Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04–2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04–3.80; immunosuppression: HR = 5.06, 95% CI 2.26–11.41; hypertension: HR = 2.30, 95% CI 1.77–3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.
【저자키워드】 COVID-19, SARS-CoV-2, coronavirus, Mortality, obesity, Comorbidities, 【초록키워드】 Meta-analysis, Asthma, Risk factors, intensive care, severe COVID-19, Pneumonia, hospital, Diabetes Mellitus, Immunosuppression, Comorbidity, risk, cardiovascular disease, Chronic kidney disease, risk factor, hypertension, adverse outcomes, adverse outcome, Cohort, survival, Patient, Model, death, statistical model, hospitalisation, Admission, Critical, patients, pulmonary disease, retrospective, Combination, mortality risk, Invasive mechanical ventilation, Analysis, Cox regression, risk of death, 95% CI, 95% confidence interval, increased risk, hazard ratio, logistic regression model, all-cause mortality, Positive test, National, Inclusion, performed, evaluated, applied, adjusted, increase, determine, positive patient, chronic obstructive, patients evaluated, 【제목키워드】 risk factor, adverse outcome, Patient, National,