Abstract
Background/objectives
Patients affected by obesity and Coronavirus disease 2019, the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), appear to have a higher risk for intensive care (ICU) admission. A state of low-grade chronic inflammation in obesity has been suggested as one of the underlying mechanisms. We investigated whether obesity is associated with differences in new inflammatory biomarkers mid-regional proadrenomedullin (MR-proADM), C-terminal proendothelin-1 (CT-proET-1), and clinical outcomes in critically ill patients with SARS-CoV-2 pneumonia.
Subjects/methods
A total of 105 critically ill patients with SARS-CoV-2 pneumonia were divided in patients with obesity (body mass index (BMI) ≥ 30 kg/m2, n = 42) and patients without obesity (BMI < 30 kg/m2, n = 63) and studied in a retrospective observational cohort study. MR-proADM, CT-proET-1 concentrations, and conventional markers of white blood count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were collected during the first 7 days.
Results
BMI was 33.5 (32–36.1) and 26.2 (24.7–27.8) kg/m2 in the group with and without obesity. There were no significant differences in concentrations MR-proADM, CT-proET-1, WBC, CRP, and PCT at baseline and the next 6 days between patients with and without obesity. Only MR-proADM changed significantly over time (p = 0.039). Also, BMI did not correlate with inflammatory biomarkers (MR-proADM rho = 0.150, p = 0.125, CT-proET-1 rho = 0.179, p = 0.067, WBC rho = −0.044, p = 0.654, CRP rho = 0.057, p = 0.564, PCT rho = 0.022, p = 0.842). Finally, no significant differences in time on a ventilator, ICU length of stay, and 28-day mortality between patients with or without obesity were observed.
Conclusions
In critically ill patients with confirmed SARS-CoV-2 pneumonia, obesity was not associated with differences in MR-proADM, and CT-proET-1, or impaired outcome.
Trial registration
Netherlands Trial Register, NL8460.
【초록키워드】 SARS-CoV-2, Coronavirus disease 2019, coronavirus, intensive care, obesity, 28-day mortality, C-reactive protein, CRP, procalcitonin, outcome, ICU, Clinical outcome, body mass index, Patient, chronic inflammation, WBC, mechanisms, BMI, SARS-CoV-2 pneumonia, Admission, Blood, MR-proADM, marker, Inflammatory biomarker, retrospective, Concentration, Critically ill patient, Observational cohort study, acute respiratory syndrome, ventilator, higher risk, no significant difference, PCT, concentrations, Result, affected, collected, caused, significantly, investigated, the disease, Netherland, suggested, changed, C-terminal, baseline, patients with obesity, 【제목키워드】 Critically ill, SARS-CoV-2 pneumonia, disease course, not different, C-terminal, patients with obesity,