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

Authors :
Hutten, Christina G
Padalia, Kishan
Vasbinder, Alexi
Huang, Yiyuan
Ismail, Anis
Pizzo, Ian
Diaz, Kristen Machado
Catalan, Tonimarie
Presswalla, Feriel
Anderson, Elizabeth
Erne, Grace
Bitterman, Brayden
Blakely, Pennelope
Giamarellos-Bourboulis, Evangelos J
Loosen, Sven H
Tacke, Frank
Chalkias, Athanasios
Reiser, Jochen
Eugen-Olsen, Jesper
Banerjee, Mousumi
Source :
Journal of Clinical Endocrinology & Metabolism; Nov2024, Vol. 109 Issue 11, p2745-2753, 9p
Publication Year :
2024

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. 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/m<superscript>2</superscript>) 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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
0021972X
Volume :
109
Issue :
11
Database :
Complementary Index
Journal :
Journal of Clinical Endocrinology & Metabolism
Publication Type :
Academic Journal
Accession number :
180267699
Full Text :
https://doi.org/10.1210/clinem/dgae273