Does There Exist an Obesity Paradox in COVID-19? Insights of the international HOPE-COVID-19-Registry

2021 
Abstract Background Obesity has been described as a protective factor in cardiovascular and other diseases being expressed as ‘obesity paradox’. However, the impact of obesity on clinical outcomes including mortality in COVID-19 has been poorly systematically investigated until now. We aimed to compare clinical outcomes among COVID-19 patients divided into three groups according to the body mass index (BMI). Methods We retrospectively collected data up to May 31st, 2020. 3635 patients were divided into three groups of BMI ( 30 kg/m2; n = 1061). Demographic, in-hospital complications, and predictors for mortality, respiratory insufficiency, and sepsis were analyzed. Results The rate of respiratory insufficiency was more recorded in BMI 25-30 kg/m2 as compared to BMI   30 kg/m2 than BMI   30 kg/m2 as compared to BMI   30 kg/m2 as compared to BMI   30 kg/m2 did not impact the mortality rate (HR 1.15, 95% CI: 0.889-1.508; p = 0.27) (HR 1.15, 95% CI: 0.893-1.479; p = 0.27). In multivariate logistic regression analyses for respiratory insufficiency and sepsis, BMI  Conclusions HOPE COVID-19-Registry revealed no evidence of obesity paradox in patients with COVID-19. However, Obesity was associated with a higher rate of respiratory insufficiency and sepsis but was not determined as an independent predictor for a high mortality.
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