학술논문
Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study.
Document Type
Academic Journal
Author
Hutten CG; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Padalia K; Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Vasbinder A; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Huang Y; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.; Ismail A; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Pizzo I; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Machado Diaz K; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Catalan T; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Presswalla F; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Anderson E; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Erne G; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Bitterman B; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Blakely P; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Giamarellos-Bourboulis EJ; 4th Department of Internal Medicine, National and Kapodistrian University of Athens, Greece.; Loosen SH; Clinic for Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany.; Tacke F; Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany.; Chalkias A; Institute for Translational Medicine and Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.; Reiser J; Department of Medicine, Rush University Medical Center, Chicago, IL, USA.; Eugen-Olsen J; Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.; Banerjee M; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI.; Pop-Busui R; Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.; Hayek SS; Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI, USA.
Source
Publisher: Oxford University Press Country of Publication: United States NLM ID: 0375362 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1945-7197 (Electronic) Linking ISSN: 0021972X NLM ISO Abbreviation: J Clin Endocrinol Metab Subsets: MEDLINE
Subject
Language
English
Abstract
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.
Design: 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.
Setting: Ten hospitals in the United States and Europe.
Participants: Adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022.
Main Outcome Measures: 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 to 1.98]) compared to non-obese 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.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
Objective: The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes.
Design: 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.
Setting: Ten hospitals in the United States and Europe.
Participants: Adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022.
Main Outcome Measures: 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 to 1.98]) compared to non-obese 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.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)