Tag Archives: obesity

Poor clinical outcomes among hospitalized obese patients with COVID-19 are related to inflammation and not respiratory mechanics

Jordan N Edwards, Tomas Ganz, Elizabeta Nemeth, Emily J Martin, Nicholas J Jackson, Airie Kim

David Geffen School of Medicine, University of California Los Angeles, CA, USA

DOI: 10.2478/jccm-2025-0012

Introduction: The coronavirus disease 2019 (COVID-19) has infected millions of people worldwide resulting in high morbidity and mortality. Obesity is known to cause metabolic derangements and precipitate worse outcomes from viral pneumonia, potentially secondary to increased inflammation and/or altered respiratory mechanics.
Aim of the Study: Our study’s aim was to examine the relationships among BMI, systemic inflammation, and respiratory mechanics in determining clinical outcomes.
Materials and Methods: This retrospective, observational cohort study included 199 adult patients with confirmed COVID-19 who were hospitalized at a quaternary-referral academic health system. Data were manually extracted from electronic medical records, including baseline demographics and clinical profiles, inflammatory markers, measures of respiratory mechanics, and clinical outcomes. We used the rank-sum test to compare the distributions of BMI and inflammatory markers between those with and without specific clinical outcomes, and the Pearson correlation to measure the correlations between BMI and inflammatory markers or respiratory mechanics.
Results: Higher BMI was associated with worse clinical outcomes, including the need for Intensive Care Unit (ICU) admission, invasive mechanical ventilation (IMV), neuromuscular blockade, and prone positioning, particularly in male patients. Inflammation, as measured by C-reactive protein, lactate dehydrogenase (LDH), ferritin, and D-Dimer, was also increased in both male and female patients who required ICU admission, IMV, neuromuscular blockade, and prone positioning. However, only male patients had a positive correlation of LDH and D-Dimer levels with BMI. There was no correlation between BMI and respiratory mechanics, as measured by static compliance and the response to prone positioning.
Conclusions: Our findings suggest that the metabolic dysfunction and systemic inflammation seen in obesity, and not dysfunctional respiratory physiology, drive the negative clinical outcomes seen in this cohort of hospitalized COVID-19 patients.

Keywords: , , , ,
Full text: PDF

Hypercoagulopathy in Overweight and Obese COVID-19 Patients: A Single-Center Case Series

Azza Sarfraz1,2, Zouina Sarfraz1,3, Aman Siddiqui1,4, Ali Totonchian4, Syed Hashim Abbas Ali Bokhari5, Hafiza Hussain3, Muzna Sarfraz1, Gaurav Patel1, Muhammad Hassaan Amjad6, Sameer Saleem Tebha1, Ivan Cherrez-Ojeda7,8, Patrick Dreyer1, Harshad Amin1, Jack Michel1

1 Larkin Health System, South Miami, FL, USA
2 Pediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
3 Research and Publications, Fatima Jinnah Medical University, Lahore, Pakistan
4 Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
5 School of Medicine, The Aga Khan University, Karachi, Pakistan
6 Neurosurgery, Sir Ganga Ram Hospital, Lahore, Pakistan
7 Allergy and Pulmonology, Universidad de Especialidades Espíritu Santo, Ecuador
8 Respiralab Research Center, Guayaquil, Ecuador

DOI: 10.2478/jccm-2021-0032

A case series is presented of five overweight or obese patients with confirmed coronavirus disease 2019 (COVID-19) in South Miami, Florida, United States. A multitude of coagulation parameters was suggestive of a hypercoagulable state among the hospitalized COVID-19 patients. This article reports various manifestations of hypercoagulable states in overweight and obese patients, such as overt bleeding consistent with disseminated intravascular coagulation, venous thromboembolism, gastrointestinal bleeding as well as retroperitoneal hematoma. All of the required admission to the intensive care unit and subsequently patients died. The characteristics of COVID-19-associated coagulopathy are atypical and warrant a further understanding of the pathophysiology to improve clinical outcomes, specifically in overweight or obese patients.

Keywords: , , , , , ,
Full text: PDF