Статья

Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study

Christina G. SelkirkDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Kishan PadaliaDepartment of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Alexi VasbinderDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Yiyuan HuangDepartment of Biostatistics, School of Public Health, University of Michigan , Ann Arbor, MI 48109 ,Anis IsmailDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Ian PizzoDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Kristen Machado DiazDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Tonimarie CatalanDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Feriel PresswallaDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Elizabeth AndersonDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Grace ErneDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Brayden BittermanDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Pennelope BlakelyDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,Evangelos J. Giamarellos‐Bourboulis4th Department of Internal Medicine, National and Kapodistrian University of Athens , Medical School, 124 62 Athens ,Sven H. LoosenClinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Düsseldorf , 40225 Düsseldorf ,Frank TackeDepartment of Hepatology and Gastroenterology, Charité—Universitätsmedizin Berlin , 13353 Berlin ,Athanasios ChalkiasInstitute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine , Philadelphia, PA 19104 ,Jochen ReiserDepartment of Medicine, Rush University Medical Center , Chicago, IL 60612 ,Jesper Eugen‐OlsenDepartment of Clinical Research, Copenhagen University Hospital Amager and Hvidovre , 2650 Hvidovre ,Mousumi BanerjeeDepartment of Biostatistics, School of Public Health, University of Michigan , Ann Arbor, MI 48109 ,Rodica Pop‐BusuiDivision of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan , Ann Arbor, MI 48109 ,Salim S. HayekDivision of Cardiology, Department of Internal Medicine, University of Michigan , Ann Arbor MI 48109 ,

2024en

ABI

Аннотация

CONTEXT: Obesity is a risk factor for coronavirus disease 2019 (COVID-19)-related outcomes; however, the mechanism remains unclear. OBJECTIVE: The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes. METHODS: The International Study of Inflammation in COVID-19 (ISIC): A Prospective Multi-Center Observational Study Examining the Role of Biomarkers of Inflammation in Predicting Covid-19 Related Outcomes in Hospitalized Patients, was conducted at 10 hospitals in the United States and Europe. Participants were adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022. Inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), were measured at admission. Associations were examined between body mass index (BMI, kg/m2) and a composite of death, need for mechanical ventilation, and renal replacement therapy, stratified by pre- and post-Omicron variants. The contribution of inflammation to the relationship between obesity and outcomes was assessed. RESULTS: Among 4644 participants (mean age 59.3, 45.6% male, 21.8% BMI ≥ 35), those with BMI > 40 (n = 485) had 55% higher odds of the composite outcome (95% CI, 1.21-1.98) compared with nonobese individuals (BMI < 30, n = 2358) in multivariable analysis. In multiple mediation analysis, only suPAR remained a significant mediator between BMI and composite outcome. Associations were amplified for participants younger than 65 years and with pre-Omicron variants. CONCLUSION: Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes.

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Идентификаторы

DOI: 10.1210/clinem/dgae273

Цитирования и источники

Цитирований: 2Использованных источников: 0

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