Association of Obesity With COVID-19 Severity and Mortality: An Updated Systemic Review, Meta-Analysis, and Meta-Regression

Frontiers in Endocrinology, Journal Year: 2022, Volume and Issue: 13

Published: June 3, 2022

Background Obesity affects the course of critical illnesses. We aimed to estimate association obesity with severity and mortality in coronavirus disease 2019 (COVID-19) patients. Data Sources A systematic search was conducted from inception COVID-19 pandemic through 13 October 2021, on databases including Medline (PubMed), Embase, Science Web, Cochrane Central Controlled Trials Registry. Preprint servers such as BioRxiv, MedRxiv, ChemRxiv, SSRN were also scanned. Study Selection Extraction Full-length articles focusing outcome patients included. Preferred Reporting Items for Systematic Reviews Meta-Analysis guidelines used study selection data extraction. Our Population interest positive patients, is our Intervention/Exposure point, Comparators are Non-obese vs obese The chief confirmed hospitalized terms admission intensive care unit (ICU) or requirement invasive mechanical ventilation/intubation obesity. All-cause secondary study. Results In total, 3,140,413 167 studies included associated an increased risk severe (RR=1.52, 95% CI 1.41-1.63, p<0.001, I 2 = 97%). Similarly, high observed (RR=1.09, 1.02-1.16, p=0.006, multivariate meta-regression severity, covariate female gender, pulmonary disease, diabetes, older age, cardiovascular diseases, hypertension found be significant explained R 40% between-study heterogeneity severity. aforementioned covariates well, these collectively 50% variability mortality. Conclusions findings suggest that significantly higher among Therefore, inclusion its surrogate body mass index prognostic scores improvement patient management recommended.

Language: Английский

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Bacterial Coinfection and Antibiotic Resistance Profiles among Hospitalised COVID-19 Patients

Microorganisms, Journal Year: 2022, Volume and Issue: 10(3), P. 495 - 495

Published: Feb. 23, 2022

While it is reported that COVID-19 patients are more prone to secondary bacterial infections, which strongly linked the severity of complications disease, coinfections associated with not widely studied. This work aimed investigate prevalence and antibiotic resistance profiles among hospitalised patients. Age, gender, weight, identities, sensitivity were collected retrospectively for 108 admitted intensive care unit (ICU) non-ICU ward a single center in Saudi Arabia. ICU (60%) showed significantly higher percentage sputum (74%) blood (38%) samples, compared non-ICU. Acinetobacter baumannii (56%) Klebsiella pneumoniae most prevalent species from patients, presenting full all tested antibiotics except colistin. By contrast, samples exhibited infections Escherichia coli (31%) Pseudomonas aeruginosa (15%) predominantly, elevated E. piperacillin/tazobactam trimethoprim/sulfamethoxazole. alarming correlation between multi-drug resistant coinfection admission requires attention precaution prescribed limit spread bacteria improve therapeutic management.

Language: Английский

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Obesity Paradox and Functional Outcomes in Sepsis: A Multicenter Prospective Study

Critical Care Medicine, Journal Year: 2023, Volume and Issue: 51(6), P. 742 - 752

Published: Feb. 9, 2023

In Asian populations, the correlation between sepsis outcomes and body mass is unclear. A multicenter, prospective, observational study conducted September 2019 December 2020 evaluated obesity's effects on in a national cohort.Nineteen tertiary referral hospitals or university-affiliated South Korea.Adult patients with ( n = 6,424) were classified into obese 1,335) nonobese groups 5,089).Obese propensity score-matched ratio of 1:1. Inhospital mortality was primary outcome. After score matching, group had higher hospital than (25.3% vs 36.7%; p < 0.001). The home discharge rate (70.3% 65.2%; 0.001) lower median Clinical Frailty Scale (CFS) (4 5; 0.007) at group, whereas proportion frail (CFS ≥ 5) significantly (48.7% 54.7%; 0.011). Patients divided four according to World Health Organization index (BMI) classification performed additional analyses. adjusted odds frailty for underweight, overweight, relative normal BMI 1.25 0.004), 0.58 0.001), 0.70 0.047) 1.53 0.80 0.095), 0.60 0.022), respectively.Obesity associated survival functional sepsis.

Language: Английский

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Global prevalence and effect of comorbidities and smoking status on severity and mortality of COVID-19 in association with age and gender: a systematic review, meta-analysis and meta-regression

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: April 19, 2023

Abstract A COVID-19 patient often presents with multiple comorbidities and is associated adverse outcomes. comprehensive assessment of the prevalence in patients essential. This study aimed to assess comorbidities, severity mortality regard geographic region, age, gender smoking status COVID-19. systematic review multistage meta-analyses were reported using PRISMA guidelines. PubMed/MEDLINE, SCOPUS, Google Scholar EMBASE searched from January 2020 October 2022. Cross-sectional studies, cohort case series case–control studies on reporting among populations that published English included. The pooled various medical conditions was calculated based regional population size weights. Stratified analyses performed understand variations gender, region. total 190 comprising 105 million Statistical STATA software, version 16 MP (StataCorp, College Station, TX). Meta-analysis proportion obtain values comorbidities: hypertension (39%, 95% CI 36–42, n = 170 studies), obesity (27%, 25–30%, 169 diabetes 175), asthma (8%, 7–9%, 112). Moreover, hospitalization 35% (95% 29–41%, 61), intensive care admissions 17% 14–21, 106), 18% 16–21%, 145). highest Europe at 44% 39–47%, 68), 30% CI, 26–34, 79) 27% (95%CI, 24–30, 80) North America, 9% 8–11, 41). Obesity high ≥ 50 years (30%, 112) age group, Men (26%, 124) observational higher than (19% vs. 14%). Random effects meta-regression found a significant association between ( p < 0.001), 0.05), ICU admission 0.05) 0.001). Overall, global (39%) lower (8%), Hence, geographical regions respective chronic should accelerate regular booster dose vaccination, preferably those prevent disease novel SARS-CoV-2 variants concern (VOC).

Language: Английский

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Characteristics and mortality of 561,379 hospitalized COVID-19 patients in Germany until December 2021 based on real-life data

Scientific Reports, Journal Year: 2022, Volume and Issue: 12(1)

Published: July 1, 2022

Abstract The ongoing SARS-CoV-2 pandemic is characterized by poor outcome and a high mortality especially in the older patient cohort. Up to this point there lack of data characterising COVID-19 patients Germany admitted intensive care (ICU) vs. non-ICU patients. German Reimbursement inpatient covering period from January 1st, 2020 December 31th, 2021 were analyzed. 561,379 hospitalized with COVID-19. 24.54% (n = 137,750) ICU. Overall hospital was 16.69% 93,668) 33.36% 45,947) ICU group. 28.66% 160,881) all suffer Cardiac arrhythmia 17.98% 100,926) developed renal failure. Obesity showed an odds-ratio ranging 0.83 (0.79–0.87) for WHO grade I 1.13 (1.08–1.19) III. Mortality-rates peaked April being 21.23% 4539) 22.99% 15,724). A third peak observed November (16.82%, n 7173 16.54%, 9416). Hospitalized lower than previously shown other studies. had be treated rate 33.36%. Congestive heart failure associated higher risk death whereas low obesity might have protective effect on survival. High admission numbers are accompanied rate.

Language: Английский

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An interpretable machine learning model for predicting in-hospital mortality in ICU patients with ventilator-associated pneumonia

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(1), P. e0316526 - e0316526

Published: Jan. 7, 2025

Background Ventilator-associated pneumonia (VAP) is a common nosocomial infection in ICU, significantly associated with poor outcomes. However, there currently lack of reliable and interpretable tools for assessing the risk in-hospital mortality VAP patients. This study aims to develop an machine learning (ML) prediction model enhance assessment Methods extracted patient data from versions 2.2 3.1 MIMIC-IV database, using version training validation, external testing. Feature selection was conducted Boruta algorithm, 14 ML models were constructed. The optimal identified based on area under receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity across both validation test cohorts. SHapley Additive exPlanations (SHAP) analysis applied global local interpretability. Results A total 1,894 patients included, 12 features ultimately selected construction: 24-hour urine output, blood urea nitrogen, age, diastolic pressure, platelet count, anion gap, body temperature, bicarbonate level, sodium mass index, whether combined congestive heart failure cerebrovascular disease. random forest (RF) showed best performance, achieving AUC 0.780 internal 0.724 testing, outperforming other clinical scoring systems. Conclusion RF demonstrated robust performance predicting developed online tool can assist clinicians efficiently risk, supporting decision-making.

Language: Английский

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Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital

PLoS ONE, Journal Year: 2022, Volume and Issue: 17(3), P. e0264789 - e0264789

Published: March 2, 2022

Objectives To determine the risk factors for in-hospital mortality in patients with COVID-19 from a Peruvian national hospital. Methods Retrospective cohort study of medical records hospitalized at Hospital Nacional Hipólito Unanue (HNHU) during months April to August 2020. The dependent variable was mortality. Independent variables included sociodemographic and clinical characteristics, physical examination findings, oxygen saturation (SaO 2 ) admission, treatment received hospitalization laboratory results admission. A Cox regression model used evaluate crude adjusted hazard ratios associated factors. Results We 1418 patients. Median age 58 years (IQR 47–68 years) 944 (66.6%) were male. median length 7 (4–13) days, rate 46%. most frequent comorbidities type diabetes mellitus, hypertension, obesity. In analysis, (HR 1.02; 95%CI 1.02–1.03), history surgery 1.89; 1.31–2.74), lower admission 4.08; CI95% 2.72–8.05 SaO <70% compared >94%), presence poor general condition 1.81; 95% CI 1.29–2.53), altered state consciousness 1.58; 1.18–2.11) leukocyte levels 1.01; 1.00–1. 02). Treatment ivermectin 1.44; 1.18–1.76) azithromycin 1.25; 1.03–1.52) higher corticosteroids low moderate doses 0.56 0. 37–0. 86) comparison no steroid use. Conclusion high found our cohort. Low age, hematological biochemical alterations use hydroxychloroquine, or not useful probably unfavorable outcomes.

Language: Английский

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Obesity Impact on SARS-CoV-2 Infection: Pros and Cons “Obesity Paradox”—A Systematic Review

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(13), P. 3844 - 3844

Published: July 2, 2022

During the last years, COVID-19 pandemic meets generated by obesity, raising many questions regarding outcomes of those with severe forms infection.

Language: Английский

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Predictive biomarkers of mortality in patients with severe COVID-19 hospitalized in intensive care unit

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: Aug. 30, 2024

This study was performed to identify predictive markers of worse outcomes in patients with severe COVID-19 an intensive care unit.

Language: Английский

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The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

Nutrients, Journal Year: 2021, Volume and Issue: 13(10), P. 3302 - 3302

Published: Sept. 22, 2021

Coronavirus disease 2019 (COVID-19) has become one of the leading causes death worldwide. The impact poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how BMI (body mass index) affected in-hospital COVID-19 Methods: We conducted a retrospective analysed medical records 286 admitted intensive unit University Clinical Hospital Wroclaw (Poland).A total were analysed. In sample group, 8% who died had within normal range, 46% overweight, obese. There was statistically significantly higher rate men (73%) those with BMIs between 25.0-29.9 (p = 0.011). Nonsurvivors HF (Heart Failure) 0.037) HT (hypertension) < 0.001). Furthermore, nonsurvivors older risk overweight (HR 2.13; p 0.038). Mortality influenced by scores parameters such as age 1.03; 0.001), NRS2002 (nutritional score, HR 1.18; 0.019), PCT (procalcitonin, 1.10; 0.001) potassium level 1.40; 0.023).Being requiring invasive mechanical ventilation increases their significantly. Additional factors indicating include patient's age, high PCT, levels, NRS ≥ 3 measured at time admission ICU.

Language: Английский

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