tetano
Editor, Senior Moderator
Diabetes Obes Metab
. 2020 Oct 14.
doi: 10.1111/dom.14228. Online ahead of print.
Relationship between obesity and severe COVID-19 outcomes in patients with type 2 diabetes: results from the CORONADO study
Sarra Smati[SUP] 1 [/SUP], Blandine Tramunt[SUP] 2 [/SUP], Matthieu Wargny[SUP] 1 3 [/SUP], Cyrielle Caussy[SUP] 4 5 [/SUP], B?n?dicte Gaborit[SUP] 6 [/SUP], Camille Vatier[SUP] 7 8 [/SUP], Bruno Verg?s[SUP] 9 [/SUP], Deborah Ancelle[SUP] 10 [/SUP], Coralie Amadou[SUP] 11 [/SUP], Leila Ait Bachir[SUP] 12 [/SUP], Olivier Bourron[SUP] 13 [/SUP], Christine Coffin-Boutreux[SUP] 14 [/SUP], Sara Barraud[SUP] 15 [/SUP], Anne Dorange[SUP] 16 [/SUP], B?n?dicte Fremy[SUP] 17 [/SUP], Jean-Fran?ois Gautier[SUP] 18 19 [/SUP], Natacha Germain[SUP] 20 [/SUP], Etienne Larger[SUP] 21 [/SUP], St?phanie Laugier-Robiolle[SUP] 22 [/SUP], Laurent Meyer[SUP] 23 [/SUP], Arnaud Monier[SUP] 24 [/SUP], Isabelle Moura[SUP] 25 [/SUP], Louis Potier[SUP] 26 [/SUP], Nadia Sabbah[SUP] 27 28 [/SUP], Dominique Seret-B?gu?[SUP] 29 [/SUP], Patrice Winiszewski[SUP] 30 [/SUP], Matthieu Pichelin[SUP] 1 [/SUP], Pierre-Jean Saulnier[SUP] 31 [/SUP], Samy Hadjadj[SUP] 1 [/SUP], Bertrand Cariou[SUP] 1 [/SUP], Pierre Gourdy[SUP] 2 [/SUP], CORONADO investigators
Affiliations
Abstract
Aims: Obesity and diabetes have been identified as comorbidities frequently associated with severe forms of COVID-19. Here, we specifically assessed the relationship between BMI classes and early COVID-19 prognosis in inpatients with type 2 diabetes (T2D).
Methods: From the CORONAvirus-SARS-CoV-2 and Diabetes Outcomes (CORONADO) study, we conducted an analysis in patients with T2D categorized in four BMI subgroups according to the World Health Organization classification. Clinical characteristics and COVID-19-related outcomes (i.e. intubation for mechanical ventilation [IMV], death and discharge by day 7 [D7]) were analyzed according to BMI status.
Results: Among 1,965 patients with T2D, 434 (22.1%) normal-weight (18.5-24.9 kg/m?, reference group), 726 (36.9%) overweight (25-29.9 kg/m?) and 805 (41.0%) obese subjects were analyzed, including 491 (25.0%) with class I obesity (30-34.9 kg/m?) and 314 (16.0%) with class II/III obesity (≥ 35 kg/m[SUP]2[/SUP] ). In a multivariable-adjusted model, the primary outcome (i.e. IMV and/or death by D7) was significantly associated with overweight (OR 1.65 [1.05-2.59]), class I (OR 1.93 [1.19-3.14]) and class II/III obesity (OR 1.98 [1.11-3.52]). After multivariable adjustment, primary outcome by D7 was significantly associated with obesity in patients under 75 years, while such association was no longer found in those over 75 years.
Conclusions: Overweight and obesity are associated with poor early prognosis in patients with T2D hospitalized for COVID-19. Importantly, the deleterious impact of obesity on COVID-19 prognosis was no longer observed in the elderly, highlighting the need for a specific management in this specific population. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; elderly; mechanical ventilation; obesity; prognosis; type 2 diabetes.
. 2020 Oct 14.
doi: 10.1111/dom.14228. Online ahead of print.
Relationship between obesity and severe COVID-19 outcomes in patients with type 2 diabetes: results from the CORONADO study
Sarra Smati[SUP] 1 [/SUP], Blandine Tramunt[SUP] 2 [/SUP], Matthieu Wargny[SUP] 1 3 [/SUP], Cyrielle Caussy[SUP] 4 5 [/SUP], B?n?dicte Gaborit[SUP] 6 [/SUP], Camille Vatier[SUP] 7 8 [/SUP], Bruno Verg?s[SUP] 9 [/SUP], Deborah Ancelle[SUP] 10 [/SUP], Coralie Amadou[SUP] 11 [/SUP], Leila Ait Bachir[SUP] 12 [/SUP], Olivier Bourron[SUP] 13 [/SUP], Christine Coffin-Boutreux[SUP] 14 [/SUP], Sara Barraud[SUP] 15 [/SUP], Anne Dorange[SUP] 16 [/SUP], B?n?dicte Fremy[SUP] 17 [/SUP], Jean-Fran?ois Gautier[SUP] 18 19 [/SUP], Natacha Germain[SUP] 20 [/SUP], Etienne Larger[SUP] 21 [/SUP], St?phanie Laugier-Robiolle[SUP] 22 [/SUP], Laurent Meyer[SUP] 23 [/SUP], Arnaud Monier[SUP] 24 [/SUP], Isabelle Moura[SUP] 25 [/SUP], Louis Potier[SUP] 26 [/SUP], Nadia Sabbah[SUP] 27 28 [/SUP], Dominique Seret-B?gu?[SUP] 29 [/SUP], Patrice Winiszewski[SUP] 30 [/SUP], Matthieu Pichelin[SUP] 1 [/SUP], Pierre-Jean Saulnier[SUP] 31 [/SUP], Samy Hadjadj[SUP] 1 [/SUP], Bertrand Cariou[SUP] 1 [/SUP], Pierre Gourdy[SUP] 2 [/SUP], CORONADO investigators
Affiliations
- PMID: 33051976
- DOI: 10.1111/dom.14228
Abstract
Aims: Obesity and diabetes have been identified as comorbidities frequently associated with severe forms of COVID-19. Here, we specifically assessed the relationship between BMI classes and early COVID-19 prognosis in inpatients with type 2 diabetes (T2D).
Methods: From the CORONAvirus-SARS-CoV-2 and Diabetes Outcomes (CORONADO) study, we conducted an analysis in patients with T2D categorized in four BMI subgroups according to the World Health Organization classification. Clinical characteristics and COVID-19-related outcomes (i.e. intubation for mechanical ventilation [IMV], death and discharge by day 7 [D7]) were analyzed according to BMI status.
Results: Among 1,965 patients with T2D, 434 (22.1%) normal-weight (18.5-24.9 kg/m?, reference group), 726 (36.9%) overweight (25-29.9 kg/m?) and 805 (41.0%) obese subjects were analyzed, including 491 (25.0%) with class I obesity (30-34.9 kg/m?) and 314 (16.0%) with class II/III obesity (≥ 35 kg/m[SUP]2[/SUP] ). In a multivariable-adjusted model, the primary outcome (i.e. IMV and/or death by D7) was significantly associated with overweight (OR 1.65 [1.05-2.59]), class I (OR 1.93 [1.19-3.14]) and class II/III obesity (OR 1.98 [1.11-3.52]). After multivariable adjustment, primary outcome by D7 was significantly associated with obesity in patients under 75 years, while such association was no longer found in those over 75 years.
Conclusions: Overweight and obesity are associated with poor early prognosis in patients with T2D hospitalized for COVID-19. Importantly, the deleterious impact of obesity on COVID-19 prognosis was no longer observed in the elderly, highlighting the need for a specific management in this specific population. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; elderly; mechanical ventilation; obesity; prognosis; type 2 diabetes.