BMI and pneumonia outcomes in critically ill COVID-19 patients: An international multicenter study
Mikael Chetboun
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
CHU Lille, Centre Intégré de l'Obésité, F-59000, Lille, France
Search for more papers by this authorVioleta Raverdy
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
CHU Lille, Centre Intégré de l'Obésité, F-59000, Lille, France
Search for more papers by this authorJulien Labreuche
ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, Univ Lille, CHU Lille, Lille, France
Search for more papers by this authorArthur Simonnet
Department of Intensive Care, CHU Lille, Univ Lille, Lille, France
Search for more papers by this authorFlorent Wallet
Medical Intensive Care Unit, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
Emerging Pathogens Laboratory-Mérieux Foundation, International Center for Infectious Disease Research, Inserm U1111, Lyon, France
Search for more papers by this authorCyrielle Caussy
Diabetes and Nutrition, Department of Endocrinology, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
CarMen Laboratory, University of Lyon, INRA, INSA, Claude Bernard Lyon 1 University, Inserm, Pierre-Bénite, France
Search for more papers by this authorMassimo Antonelli
Department of Anesthesia and Intensive Care Medicine, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
Search for more papers by this authorAntonio Artigas
Critical Care Department, Parc Tauli University Health Corporation, CIBER Respiratory Diseases, Sabadell, Spain
Department of Medicine, Autonomous University of Barcelona, Bellaterra, Spain
Search for more papers by this authorGemma Goma
Critical Care Department, Parc Tauli University Health Corporation, Sabadell, Spain
Search for more papers by this authorFerhat Meziani
Intensive Care Medicine Department, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
Inserm U1260, Regenerative Nanomedicine, University of Strasbourg, Strasbourg, France
Search for more papers by this authorJulie Helms
Intensive Care Medicine Department, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
Inserm Unit_S1109, LabEx TRANSPLANTEX, Immunology and Hematology Research Center, Faculty of Medicine, University of Strasbourg, Strasbourg, France
Search for more papers by this authorEleftherios Mylonakis
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Rhode Island Hospital and the Miriam Hospital, Providence, Rhode Island, USA
Search for more papers by this authorMitchell M. Levy
Rhode Island Hospital and the Miriam Hospital, Providence, Rhode Island, USA
Division of Critical Care, Pulmonary, and Sleep Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorMarkos Kalligeros
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Rhode Island Hospital and the Miriam Hospital, Providence, Rhode Island, USA
Search for more papers by this authorNicola Latronico
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Bresica, Italy
Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
Search for more papers by this authorSimone Piva
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Bresica, Italy
Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
Search for more papers by this authorCharles Cerf
Medico-Surgical Intensive Care Unit, Foch Hospital, Suresnes, France
Search for more papers by this authorMathilde Neuville
Medico-Surgical Intensive Care Unit, Foch Hospital, Suresnes, France
Search for more papers by this authorKada Klouche
Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
PhyMedExp, University of Montpellier, Inserm, CNRS, Montpellier, France
Search for more papers by this authorRomaric Larcher
Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
PhyMedExp, University of Montpellier, Inserm, CNRS, Montpellier, France
Search for more papers by this authorFabienne Tamion
Medical Intensive Care Unit, University Hospital, Rouen, France
Normandie Univ, UNIROUEN, Inserm U1096, FHU- REMOD-VHF, Rouen, France
Search for more papers by this authorEmilie Occhiali
Department of Anesthesia, Critical Care and Perioperative Medecine, Rouen University Hospital, Rouen, France
Search for more papers by this authorMorgane Snacken
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Search for more papers by this authorJean-Charles Preiser
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Search for more papers by this authorLoay Kontar
Medical Intensive Care Unit, Amiens University Hospital, Amiens, France
Search for more papers by this authorAntoine Riviere
Intensive Care Unit, Abbeville General Hospital, Abbeville, France
Search for more papers by this authorStein Silva
Critical Care Unit, University Hospital of Purpan, Toulouse, France
ToNIC, Toulouse NeuroImaging Center, Inserm 1214, Paul Sabatier University, Toulouse, France
Search for more papers by this authorBenjamine Sarton
Critical Care Unit, University Hospital of Purpan, Toulouse, France
ToNIC, Toulouse NeuroImaging Center, Inserm 1214, Paul Sabatier University, Toulouse, France
Search for more papers by this authorRaphael Krouchi
Intensive Care Unit, Dunkerque Hospital Center, Dunkerque, France
Search for more papers by this authorVictoria Dubar
Intensive Care Unit, Dunkerque Hospital Center, Dunkerque, France
Search for more papers by this authorLeonidas Palaiodimos
Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
Search for more papers by this authorDimitrios Karamanis
Department of Economics, University of Piraeus, Piraeus, Attica, Greece
Search for more papers by this authorJuliette Perche
Roubaix Hospital, Intensive Care Unit, Roubaix, France
Search for more papers by this authorErwan L'Her
Intensive Care Unit, Regional University Hospital of Brest La Cavale Blanche, Brest, France
LATIM Inserm UMR 1101, Université de Bretagne Occidentale, Brest, France
Search for more papers by this authorLuca Busetto
Department of Medicine, University of Padova, Padova, Italy
Search for more papers by this authorDror Dicker
Internal Medicine D, Hasharon Hospital-Rabin Medical Center, Petach-Tikva, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorShaul Lev
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
General Intensive Care Unit, Hasharon Hospital-Rabin Medical Center, Petach-Tikva, Israel
Search for more papers by this authorAlain Duhamel
ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, Univ Lille, CHU Lille, Lille, France
Search for more papers by this authorCorresponding Author
Mercè Jourdain
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
Department of Intensive Care, CHU Lille, Univ Lille, Lille, France
Correspondence
François Pattou, Centre Hospitalier Universitaire de Lille, Chirurgie Génerale et Endocrinienne, Centre Integré de l'Obésité, Hôpital Huriez, 1 rue Polonovski, 59000 Lille, France.
Email: [email protected]
and
Mercè Jourdain, Centre Hospitalier Universitaire de Lille, Pôle Réanimation, Hôpital Roger Salengro, avenue du Professeur Emile Laine, 59000 Lille, France.
Email: [email protected]
Search for more papers by this authorCorresponding Author
François Pattou
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
CHU Lille, Centre Intégré de l'Obésité, F-59000, Lille, France
Correspondence
François Pattou, Centre Hospitalier Universitaire de Lille, Chirurgie Génerale et Endocrinienne, Centre Integré de l'Obésité, Hôpital Huriez, 1 rue Polonovski, 59000 Lille, France.
Email: [email protected]
and
Mercè Jourdain, Centre Hospitalier Universitaire de Lille, Pôle Réanimation, Hôpital Roger Salengro, avenue du Professeur Emile Laine, 59000 Lille, France.
Email: [email protected]
Search for more papers by this authorMikael Chetboun
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
CHU Lille, Centre Intégré de l'Obésité, F-59000, Lille, France
Search for more papers by this authorVioleta Raverdy
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
CHU Lille, Centre Intégré de l'Obésité, F-59000, Lille, France
Search for more papers by this authorJulien Labreuche
ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, Univ Lille, CHU Lille, Lille, France
Search for more papers by this authorArthur Simonnet
Department of Intensive Care, CHU Lille, Univ Lille, Lille, France
Search for more papers by this authorFlorent Wallet
Medical Intensive Care Unit, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
Emerging Pathogens Laboratory-Mérieux Foundation, International Center for Infectious Disease Research, Inserm U1111, Lyon, France
Search for more papers by this authorCyrielle Caussy
Diabetes and Nutrition, Department of Endocrinology, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France
CarMen Laboratory, University of Lyon, INRA, INSA, Claude Bernard Lyon 1 University, Inserm, Pierre-Bénite, France
Search for more papers by this authorMassimo Antonelli
Department of Anesthesia and Intensive Care Medicine, Fondazione Policlinico Universitario, A. Gemelli IRCCS, Rome, Italy
Search for more papers by this authorAntonio Artigas
Critical Care Department, Parc Tauli University Health Corporation, CIBER Respiratory Diseases, Sabadell, Spain
Department of Medicine, Autonomous University of Barcelona, Bellaterra, Spain
Search for more papers by this authorGemma Goma
Critical Care Department, Parc Tauli University Health Corporation, Sabadell, Spain
Search for more papers by this authorFerhat Meziani
Intensive Care Medicine Department, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
Inserm U1260, Regenerative Nanomedicine, University of Strasbourg, Strasbourg, France
Search for more papers by this authorJulie Helms
Intensive Care Medicine Department, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France
Inserm Unit_S1109, LabEx TRANSPLANTEX, Immunology and Hematology Research Center, Faculty of Medicine, University of Strasbourg, Strasbourg, France
Search for more papers by this authorEleftherios Mylonakis
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Rhode Island Hospital and the Miriam Hospital, Providence, Rhode Island, USA
Search for more papers by this authorMitchell M. Levy
Rhode Island Hospital and the Miriam Hospital, Providence, Rhode Island, USA
Division of Critical Care, Pulmonary, and Sleep Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorMarkos Kalligeros
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Rhode Island Hospital and the Miriam Hospital, Providence, Rhode Island, USA
Search for more papers by this authorNicola Latronico
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Bresica, Italy
Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
Search for more papers by this authorSimone Piva
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Bresica, Italy
Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
Search for more papers by this authorCharles Cerf
Medico-Surgical Intensive Care Unit, Foch Hospital, Suresnes, France
Search for more papers by this authorMathilde Neuville
Medico-Surgical Intensive Care Unit, Foch Hospital, Suresnes, France
Search for more papers by this authorKada Klouche
Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
PhyMedExp, University of Montpellier, Inserm, CNRS, Montpellier, France
Search for more papers by this authorRomaric Larcher
Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
PhyMedExp, University of Montpellier, Inserm, CNRS, Montpellier, France
Search for more papers by this authorFabienne Tamion
Medical Intensive Care Unit, University Hospital, Rouen, France
Normandie Univ, UNIROUEN, Inserm U1096, FHU- REMOD-VHF, Rouen, France
Search for more papers by this authorEmilie Occhiali
Department of Anesthesia, Critical Care and Perioperative Medecine, Rouen University Hospital, Rouen, France
Search for more papers by this authorMorgane Snacken
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Search for more papers by this authorJean-Charles Preiser
Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
Search for more papers by this authorLoay Kontar
Medical Intensive Care Unit, Amiens University Hospital, Amiens, France
Search for more papers by this authorAntoine Riviere
Intensive Care Unit, Abbeville General Hospital, Abbeville, France
Search for more papers by this authorStein Silva
Critical Care Unit, University Hospital of Purpan, Toulouse, France
ToNIC, Toulouse NeuroImaging Center, Inserm 1214, Paul Sabatier University, Toulouse, France
Search for more papers by this authorBenjamine Sarton
Critical Care Unit, University Hospital of Purpan, Toulouse, France
ToNIC, Toulouse NeuroImaging Center, Inserm 1214, Paul Sabatier University, Toulouse, France
Search for more papers by this authorRaphael Krouchi
Intensive Care Unit, Dunkerque Hospital Center, Dunkerque, France
Search for more papers by this authorVictoria Dubar
Intensive Care Unit, Dunkerque Hospital Center, Dunkerque, France
Search for more papers by this authorLeonidas Palaiodimos
Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
Search for more papers by this authorDimitrios Karamanis
Department of Economics, University of Piraeus, Piraeus, Attica, Greece
Search for more papers by this authorJuliette Perche
Roubaix Hospital, Intensive Care Unit, Roubaix, France
Search for more papers by this authorErwan L'Her
Intensive Care Unit, Regional University Hospital of Brest La Cavale Blanche, Brest, France
LATIM Inserm UMR 1101, Université de Bretagne Occidentale, Brest, France
Search for more papers by this authorLuca Busetto
Department of Medicine, University of Padova, Padova, Italy
Search for more papers by this authorDror Dicker
Internal Medicine D, Hasharon Hospital-Rabin Medical Center, Petach-Tikva, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Search for more papers by this authorShaul Lev
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
General Intensive Care Unit, Hasharon Hospital-Rabin Medical Center, Petach-Tikva, Israel
Search for more papers by this authorAlain Duhamel
ULR 2694 - METRICS: Assessment of Health Technologies and Medical Practices, Univ Lille, CHU Lille, Lille, France
Search for more papers by this authorCorresponding Author
Mercè Jourdain
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
Department of Intensive Care, CHU Lille, Univ Lille, Lille, France
Correspondence
François Pattou, Centre Hospitalier Universitaire de Lille, Chirurgie Génerale et Endocrinienne, Centre Integré de l'Obésité, Hôpital Huriez, 1 rue Polonovski, 59000 Lille, France.
Email: [email protected]
and
Mercè Jourdain, Centre Hospitalier Universitaire de Lille, Pôle Réanimation, Hôpital Roger Salengro, avenue du Professeur Emile Laine, 59000 Lille, France.
Email: [email protected]
Search for more papers by this authorCorresponding Author
François Pattou
Univ Lille, Inserm, Lille Pasteur Institute, European Genomic Institute for Diabetes, U1190, F-59000, Lille, France
CHU Lille, Centre Intégré de l'Obésité, F-59000, Lille, France
Correspondence
François Pattou, Centre Hospitalier Universitaire de Lille, Chirurgie Génerale et Endocrinienne, Centre Integré de l'Obésité, Hôpital Huriez, 1 rue Polonovski, 59000 Lille, France.
Email: [email protected]
and
Mercè Jourdain, Centre Hospitalier Universitaire de Lille, Pôle Réanimation, Hôpital Roger Salengro, avenue du Professeur Emile Laine, 59000 Lille, France.
Email: [email protected]
Search for more papers by this authorMikael Chetboun and Violeta Raverdy are co-first authors.
Mercè Jourdain and François Pattou are co-last authors.
On behalf of the “LICORNE Lille Intensive Care COVID-19 and Obesity Study Group” (Lille, France); the “COVID-19 Toulouse Intensive Care Unit Network” (Toulouse, France); the “Hasharon Hospital-Rabin Medical Center Covid-19 and Obesity Study Group” (Petach-Tikva, Israel); the “ID and ICU Covid-19 Study Group” (Providence, Rhode Island); the “Rouen Covid-19 and Obesity Study” (Rouen, France); the “COVID-O-HCL Consortium” (Lyon, France); the “MICU Lapeyronie” (Montpellier, France); the “Bronx COVID-19 and Obesity Study Group” (Bronx, New York); the “MIR Amiens Covid19” (Amiens, France); the “Strasbourg NHC” (Strasbourg, France); and the “Foch COVID-19 Study Group” Suresnes, France.
A complete list of co-authors can be found in online Supporting Information.
Abstract
Objective
Previous studies have unveiled a relationship between the severity of coronavirus disease 2019 (COVID-19) pneumonia and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of BMI and associated metabolic risk factors (diabetes, hypertension, hyperlipidemia, and current smoking status) in critically ill patients with COVID-19.
Methods
Patients admitted to intensive care units for COVID-19 in 21 centers (in Europe, Israel, and the United States) were enrolled in this study between February 19, 2020, and May 19, 2020. Primary and secondary outcomes were the need for invasive mechanical ventilation (IMV) and 28-day mortality, respectively.
Results
A total of 1,461 patients were enrolled; the median (interquartile range) age was 64 years (40.9-72.0); 73.2% of patients were male; the median BMI was 28.1 kg/m2 (25.4-32.3); a total of 1,080 patients (73.9%) required IMV; and the 28-day mortality estimate was 36.1% (95% CI: 33.0-39.5). An adjusted mixed logistic regression model showed a significant linear relationship between BMI and IMV: odds ratio = 1.27 (95% CI: 1.12-1.45) per 5 kg/m2. An adjusted Cox proportional hazards regression model showed a significant association between BMI and mortality, which was increased only in obesity class III (≥40; hazard ratio = 1.68 [95% CI: 1.06-2.64]).
Conclusions
In critically ill COVID-19 patients, a linear association between BMI and the need for IMV, independent of other metabolic risk factors, and a nonlinear association between BMI and mortality risk were observed.
CONFLICT OF INTEREST
The authors declared no conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| oby23223-sup-0001-Supinfo.docxWord document, 1.1 MB | Supplementary Material |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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