Science

Arthur Simonnet, Mikael Chetboun, Julien Poissy, Violeta Raverdy, Jerome Noulette, Alain Duhamel, Julien Labreuche, Daniel Mathieu, Francois Pattou, Merce Jourdain

Objective:
The Covid‐19 pandemic is rapidly spreading worldwide, notably in Europe and North America, where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) has not been fully documented.
Methods:
In this retrospective cohort study we analyzed the relationship between clinical characteristics, including body mass index (BMI), and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted in intensive care for SARS‐CoV‐2, in a single French center.
Results:
Obesity (BMI greater than 30 kg/m2) and severe obesity (BMI greater than 35 kg/m2) were present in 47.6% and 28.2% of cases, respectively. Overall, 85 patients (68.6%) required IMV. The proportion of patients who required IMV increased with BMI categories (p less than 0.01, Chi square test for trend), and it was greatest in patients with BMI greater than 35 kg/m2 (85.7%). In multivariate logistic regression, the need for IMV was significantly associated with male sex (p less than 0.05) and BMI (p less than 0.05), independent of age, diabetes, and hypertension. The odds ratio for IMV in patients with BMI greater than 35 kg/m2 vs patients with BMI less than 25 kg/m2 was 7.36 (1.63‐33.14; p = 0.02).
Conclusion:
The present study showed a high frequency of obesity among patients admitted in intensive care for SARS‐CoV‐2. Disease severity increased with BMI. Obesity is a risk factor for SARS‐CoV‐2 severity requiring increased attention to preventive measures in susceptible individuals.