Obesity, diabetes, hypertension and severe outcomes among inpatients with COVID-19: a nationwide study
| العنوان: | Obesity, diabetes, hypertension and severe outcomes among inpatients with COVID-19: a nationwide study |
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| المؤلفون: | Bailly, Laurent, Fabre, Roxane, Courjon, Johan, Carles, Michel, Dellamonica, Jean, Pradier, Christian |
| المصدر: | Clinical Microbiology and Infection |
| بيانات النشر: | European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd., 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | hospital mortality, Adult, Aged, 80 and over, Male, Inpatients, Adolescent, Diabetes, COVID-19, Comorbidity, mechanical ventilation, Middle Aged, Respiration, Artificial, Young Adult, Risk factors, Hypertension, Diabetes Mellitus, Humans, Original Article, Female, Obesity, Aged, Retrospective Studies |
| الوصف: | Objectives Initial studies of COVID-19 patients revealed that obesity, diabetes and hypertension were associated with severe outcomes. Subsequently, some authors showed that the risk could vary according to age, gender, comorbidities and medical history. In a nationwide retrospective cohort, we studied the association between these comorbidities and patients’ requirement for invasive mechanical ventilation (IMV) or their death. Methods All French COVID-19 adult inpatients admitted during the first epidemic wave (February to September 2020) were included. When patients were diagnosed with obesity, diabetes or hypertension for the first time in 2020, these conditions were considered as incident comorbidities, otherwise as prevalent. We compared outcomes of IMV and in-hospital death according to obesity, diabetes, and hypertension, taking age, gender and Charlson’s comorbidity index score (CCIS) into account. Results 134,209 adult inpatients with COVID-19 were included, half of them had hypertension (N=66,613, 49.6%) and one in four were diabetic (N=32,209, 24.0%) or with obesity (N=32,070, 23.9%). Among this cohort, IMV was required for 13,596 inpatients, and 19,969 patients died. IMV and death were more frequent in male patients (Adj.OR=2.0 [95%CI:1.9-2.1] and Adj.OR=1.5 [95%CI:1.4-1.5], respectively), IMV in patients with comorbidities (Adj.OR=2.1 [95%CI:2.0-2.2] for CCIS=2 and Adj.OR=3.0 [95%CI:2.8-3.1] for CCIS≥5), and death in patients aged 80 or above (Adj.OR=17.0 [95%CI:15.5-18.6]). Adjusted on age, gender and CCIS, death was more frequent among inpatients with obesity (Adj.OR=1.2 [95%CI:1.1-1.2]) and diabetes (Adj.OR=1.2 [95%CI:1.1-1.2]). IMV was more frequently necessary for inpatients with obesity (Adj.OR=1.9 [95%CI:1.8-2.0]), diabetes (Adj.OR=1.4 [95%CI:1.3-1.4]) and hypertension (Adj.OR=1.7 [95%CI:1.6-1.8]). Comparatively, IMV was more often required for patients with the following incident comorbidities: obesity (Adj.OR=3.5 [95%CI:3.3-3.7]), diabetes (Adj.OR=2.0 [95%CI:1.8-2.1]) and hypertension (Adj.OR=2.5 [95%CI:2.4-2.6]). Conclusions Among 134,209 inpatients with COVID-19, mortality was more frequent among patients with obesity and diabetes. IMV was more frequently necessary for inpatients with obesity, diabetes and hypertension. Patients for whom these were incident comorbidities were particularly at risk. Specific medical monitoring and vaccination should be priorities for patients with these comorbidities. Graphical abstract Image 1 |
| اللغة: | English |
| تدمد: | 1469-0691 1198-743X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=pmid________::e00487fa1457fdc05a893638ea83db19Test http://europepmc.org/articles/PMC8444420Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.pmid..........e00487fa1457fdc05a893638ea83db19 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14690691 1198743X |
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