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Obesity Is One of the Strongest Risk Factor for Respiratory Failure and Death in COVID-19 Patients: A Retrospective Multicentric Cohort Study

32 Pages Posted: 12 May 2020

See all articles by Matteo Rottoli

Matteo Rottoli

University of Bologna - Surgery of the Alimentary Tract; Alma Mater Studiorum University of Bologna - Centre for the Study and Research of the Treatment for the Morbid Obesity

Paolo Bernante

University of Bologna - Surgery of the Alimentary Tract

Angela Belvedere

University of Bologna - Surgery of the Alimentary Tract

Tommaso Tonetti

University of Bologna - Intensive Care Unit

Silvia Garelli

Alma Mater Studiorum University of Bologna - Centre for the Study and Research of the Treatment for the Morbid Obesity

Maddalena Giannella

University of Bologna - Infectious Diseases Unit

Alessandra Cascavilla

University of Bologna - Infectious Diseases Unit

Sara Tedeschi

University of Bologna - Infectious Diseases Unit

Stefano Ianniruberto

University of Bologna - Infectious Diseases Unit

Elena Rosselli Del Turco

University of Bologna - Infectious Diseases Unit

Francesco Cristini

Rimini-Forlì-Cesena Hospitals - Infectious Diseases Unit

Francesco Barchiesi

Azienda Ospedaliera Ospedali Riuniti Marche Nord - Infectious Diseases Unit

Linda Bussini

University of Bologna - Infectious Diseases Unit

Mauro Codeluppi

Guglielmo da Saliceto Hospital - Infectious Diseases Unit

Massimo Puoti

Grande Ospedale Metropolitano Niguarda - Division of Infectious Diseases

Annalisa aracino

Grande Ospedale Metropolitano Niguarda - Division of Infectious Diseases

Elena Nardi

Alma Mater Studiorum University of Bologna - Department of Medical and Surgical Sciences

Uberto Pagotto

Alma Mater Studiorum University of Bologna - Centre for the Study and Research of the Treatment for the Morbid Obesity

Gilberto Poggioli

University of Bologna - Surgery of the Alimentary Tract

Vito Marco Ranieri

University of Bologna - Intensive Care Unit

Pierluigi Viale

University of Bologna - Infectious Diseases Unit

Michele Bartoletti

University of Bologna - Infectious Diseases Unit

More...

Abstract

Background: A significant spread of Coronavirus Disease 19 (COVID-19) has been observed in Western countries. The aim of the study was to analyze whether obesity (BMI ≥ 30 kg/m2) was a risk factor for respiratory failure and death.

Methods: Retrospective multicentric cohort study of 296 COVID-19 patients admitted to the hospital between February 28 and March 28, 2020. Demographic characteristics, laboratory findings and clinical scores were compared in obese and non-obese patients. Multivariable analysis was carried out to identify the risk factors for respiratory failure and mortality.

Findings: Of 296 patients, 70 (23·6%) had a BMI ≥ 30 kg/m2. Obese patients were significantly older (68±13·5 vs. 63±16·8, p=0·0052) and reported a higher rate of hypertension (77.9% vs. 40.2%, p<0.0001), chronic obstructive pulmonary disease (COPD) (24·3% vs. 9·7%, p=0·0017), type 2 diabetes (18·6% vs. 9·3%, p=0·033) and moderate/severe renal disease (12·9% vs. 2·7%, p=0·0007). Obese patients were more likely to require continuous positive airway pressure (20% vs. 7·8%, p=0·0052), non-invasive ventilation (20% vs. 7·5%, p=0·0061) and intensive care admission (40% vs. 15·9%, p<0·0001). At multivariable analysis, age and obesity were the only significant risk factors for the onset of respiratory failure (odds ratio [OR] 1·04, p<0·0001; OR 3·16, p=0·001) and mortality (OR 1·10, p<0.0001; OR 3·11, p=0·008).

Interpretation: Obesity is the strongest risk factor for respiratory failure and death among COVID-19 patients. Taking into account the high prevalence of obesity in the Western countries, prompt evaluation and aggressive treatment are advisable in obese patients.

Funding Statement: No funding was received for the study.

Declaration of Interests: The authors state that no conflicts of interest exist.

Ethics Approval Statement: The study was approved by the Ethical Committees of the participating centres.

Keywords: obesity; COVID-19; SARS-CoV-2; outcome; death; respiratory failure

Suggested Citation

Rottoli, Matteo and Bernante, Paolo and Belvedere, Angela and Tonetti, Tommaso and Garelli, Silvia and Giannella, Maddalena and Cascavilla, Alessandra and Tedeschi, Sara and Ianniruberto, Stefano and Del Turco, Elena Rosselli and Cristini, Francesco and Barchiesi, Francesco and Bussini, Linda and Codeluppi, Mauro and Puoti, Massimo and aracino, Annalisa and Nardi, Elena and Pagotto, Uberto and Poggioli, Gilberto and Ranieri, Vito Marco and Viale, Pierluigi and Bartoletti, Michele, Obesity Is One of the Strongest Risk Factor for Respiratory Failure and Death in COVID-19 Patients: A Retrospective Multicentric Cohort Study (4/16/2020). Available at SSRN: https://ssrn.com/abstract=3578779 or http://dx.doi.org/10.2139/ssrn.3578779

Matteo Rottoli (Contact Author)

University of Bologna - Surgery of the Alimentary Tract ( email )

Bologna
Italy
+390512145262 (Phone)

Alma Mater Studiorum University of Bologna - Centre for the Study and Research of the Treatment for the Morbid Obesity

Bologna
Italy
+390512145262 (Phone)

Paolo Bernante

University of Bologna - Surgery of the Alimentary Tract

Bologna
Italy

Angela Belvedere

University of Bologna - Surgery of the Alimentary Tract

Bologna
Italy

Tommaso Tonetti

University of Bologna - Intensive Care Unit

Italy

Silvia Garelli

Alma Mater Studiorum University of Bologna - Centre for the Study and Research of the Treatment for the Morbid Obesity

Bologna
Italy

Maddalena Giannella

University of Bologna - Infectious Diseases Unit

Italy

Alessandra Cascavilla

University of Bologna - Infectious Diseases Unit

Italy

Sara Tedeschi

University of Bologna - Infectious Diseases Unit

Italy

Stefano Ianniruberto

University of Bologna - Infectious Diseases Unit

Italy

Elena Rosselli Del Turco

University of Bologna - Infectious Diseases Unit

Italy

Francesco Cristini

Rimini-Forlì-Cesena Hospitals - Infectious Diseases Unit

Rimini
Italy

Francesco Barchiesi

Azienda Ospedaliera Ospedali Riuniti Marche Nord - Infectious Diseases Unit

Pesaro
Italy

Linda Bussini

University of Bologna - Infectious Diseases Unit

Italy

Mauro Codeluppi

Guglielmo da Saliceto Hospital - Infectious Diseases Unit

Piacenza
Italy

Massimo Puoti

Grande Ospedale Metropolitano Niguarda - Division of Infectious Diseases

Milan
Italy

Annalisa Aracino

Grande Ospedale Metropolitano Niguarda - Division of Infectious Diseases

Milan
Italy

Elena Nardi

Alma Mater Studiorum University of Bologna - Department of Medical and Surgical Sciences

Bologna
Italy

Uberto Pagotto

Alma Mater Studiorum University of Bologna - Centre for the Study and Research of the Treatment for the Morbid Obesity

Bologna
Italy

Gilberto Poggioli

University of Bologna - Surgery of the Alimentary Tract

Bologna
Italy

Vito Marco Ranieri

University of Bologna - Intensive Care Unit

Italy

Pierluigi Viale

University of Bologna - Infectious Diseases Unit

Italy

Michele Bartoletti

University of Bologna - Infectious Diseases Unit

Italy