Risk factors associated with COVID-19 in obese patients treated at a hospital in Western Bahia

Authors

DOI:

https://doi.org/10.12957/demetra.2025.83144

Keywords:

COVID-19. Obesity. Risk factors. Hospitalization.

Abstract

Objective: To identify the risk factors associated with COVID-19 in patients with obesity. Methods: This is a retrospective study based on data collected from the medical records of hospitalized patients diagnosed with COVID-19 between January 2020 and February 2022. Information was collected on nutritional diagnosis based on anthropometric measurements of body weight and height, self-reported variables at admission by the patient or guardian, personal data, medical history, and clinical data. Statistical tests of association were used to verify the relationship between the independent variables and obesity, using Poisson regression models. Results: The prevalence of obesity was 40.2% in the 549 patients studied. An association was found between obesity and the number of comorbidities (p=0.001). Regarding the symptoms and clinical aspects of the patients, there was a significant association between obesity and the use of extracorporeal oxygenation (p=0.043). There was an inverse association between obesity and age, with obese patients being 1.88 times more likely to have cardiovascular diseases (95%CI 1.415; 2.500) and 1.31 times more likely to have respiratory distress (95%CI 1.046; 1.732). Conclusions: The number of comorbidities, coexistence of cardiovascular diseases, respiratory distress, and use of extracorporeal oxygenation were associated with obesity in these patients. In addition, it was found that the cases of COVID-19 and obesity in this group were mainly adults.

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References

1. Mohammadian Khonsari N, Khashayar P, Shahrestanaki E, Kelishadi R, Mohammadpoor Nami S, Heidari-Beni M, Esmaeili Abdar Z, Tabatabaei-Malazy O, Qorbani M. Normal weight obesity and cardiometabolic risk factors: a systematic review and meta-analysis. Frontiers in Endocrinology. 2022 Mar 24;13:857930. https://doi.org/10.3389/fendo.2022.857930

2. Apovian CM. Obesity: definition, comorbidities, causes, and burden. The American Journal of Managed Care [Internet]. 2016 Jun 1;22(7 Suppl):s176-185.

3. World Health Organization. WHO acceleration plan to stop obesity [Internet]. www.who.int. [Acesso em 17 dez 2023]. Disponível em: https://www.who.int/publications/i/item/9789240075634

4. Di Giacinto I, Guarnera M, Esposito C, Falcetta S, Cortese G, Pascarella G, Sorbello M, Cataldo R. Emergencies in obese patients: a narrative review. Journal of Anesthesia, Analgesia and Critical Care. 2021 Dec;1(1):1-2. https://dx.doi.org/10.1186/s44158-021-00019-2

5. Yang J, Tian C, Chen Y, Zhu C, Chi H, Li J. Obesity aggravates COVID‐19: an updated systematic review and meta‐analysis. Journal of medical virology. 2021 May;93(5):2662-74. https://doi.org/10.1002/jmv.26237

6. Mapengo-Domingos M a. A, de Azevedo-Silva LJ, Bonato RCS, Sales Peres MC, Pinto ACS, Santiago Júnior JF, et al. Impacto da COVID-19 em indivíduos obesos: revisão sistemática e meta-análise. Brazilian Oral Research [Internet]. 2021 [Acesso em 11 dez 2023]; Disponível em: https://repositorio.usp.br/item/003064254

7. Pettit NN, MacKenzie EL, Ridgway JP, Pursell K, Ash D, Patel B, Pho MT. Obesity is associated with increased risk for mortality among hospitalized patients with COVID‐19. Obesity. 2020 Oct;28(10):1806-10. https://doi.org/10.1002%2Foby.22941

8. Heubner L, Petrick PL, Güldner A, Bartels L, Ragaller M, Mirus M, Rand A, Tiebel O, Beyer-Westendorf J, Rößler M, Schmitt J. Extreme obesity is a strong predictor for in-hospital mortality and the prevalence of long-COVID in severe COVID-19 patients with acute respiratory distress syndrome. Scientific Reports. 2022 Nov 1;12(1):18418. https://doi.org/10.1038/s41598-022-22107-1

9. Alves TC, Guimarães RS, de Souza SF, Brandão NA, da Cunha Daltro CH, Conceição-Machado ME, de Oliveira LP, de Magalhães Cunha C. Influence of nutritional assistance on mortality by COVID-19 in critically ill patients. Clinical nutrition ESPEN. 2021 Aug 1;44:469-71. https://doi.org/10.1016/j.clnesp.2021.05.016

10. Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC infectious diseases. 2021 Aug 21;21(1):855. https://doi.org/10.1186/s12879-021-06536-3

11. Organización Mundial de la Salud. El estado físico: uso e interpretación de la antropometría. Ginebra: OMS; 1995. (Serie de Informes Técnicos; 854).

12. Nagy É, Cseh V, Barcs I, Ludwig E. The Impact of Comorbidities and Obesity on the Severity and Outcome of COVID-19 in Hospitalized Patients—A Retrospective Study in a Hungarian Hospital. International Journal of Environmental Research and Public Health. 2023 Jan 12;20(2):1372. https://doi.org/10.3390/ijerph20021372

13. Ministério da Saúde. Boletim Epidemiológico no 145- Boletim COE Coronavírus — Ministério da Saúde [Internet]. www.gov.br. [Acesso em 25 nov 2023]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/covid-19/2022/boletim-epidemiologico-no-145-boletim-coe-coronavirus/view

14. Alharbi AH, Rabbani SI, Halim Mohamed AA, Almushayti BK, Aldhwayan NI, Almohaimeed AT, Alharbi AA, Alharbi NS, Asdaq SM, Alamri AS, Alsanie WF. Analysis of potential risk factors associated with COVID-19 and hospitalization. Frontiers in public health. 2022 Aug 5;10:921953. https://doi.org/10.3389/fpubh.2022.921953

15. Chait A, Den Hartigh LJ. Adipose tissue distribution, inflammation and its metabolic consequences, including diabetes and cardiovascular disease. Frontiers in cardiovascular medicine. 2020 Feb 25;7:22. https://doi.org/10.3389/fcvm.2020.00022

16. De Sa-Ferreira CO, da Costa CH, Guimarães JC, Sampaio NS, Silva LD, de Mascarenhas LP, Rodrigues NG, Dos Santos TL, Campos S, Young EC. Diabetic ketoacidosis and COVID-19: what have we learned so far?. American Journal of Physiology-Endocrinology and Metabolism. 2022 Jan 1;322(1):E44-53. https://doi.org/10.1152/ajpendo.00244.2021

17. Asturian K. O papel dos inibidores da enzima conversora de angiotensina e dos antagonistas dos receptores de angiotensina em pacientes com Covid-19: uma revisão narrativa. Revista de Ciências Médicas. 2021 Mar 10;30:1-7. https://doi.org/10.24220/2318-0897v30e2021a5035

18. Beyerstedt S, Casaro EB, Rangel ÉB. COVID-19: angiotensin-converting enzyme 2 (ACE2) expression and tissue susceptibility to SARS-CoV-2 infection. European journal of clinical microbiology & infectious diseases. 2021 May;40:905-19. https://doi.org/10.1007/s10096-020-04138-6

19. Vera-Zertuche JM, Mancilla-Galindo J, Tlalpa-Prisco M, Aguilar-Alonso P, Aguirre-García MM, Segura-Badilla O, Lazcano-Hernández M, Rocha-González HI, Navarro-Cruz AR, Kammar-García A, Vidal-Mayo JD. Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study. Epidemiology & Infection. 2021;149. https://doi.org/10.1017/s0950268821001023

20. Li Y, Xu Q, Ma L, Wu D, Gao J, Chen G, Li H. Systematic profiling of ACE2 expression in diverse physiological and pathological conditions for COVID‐19/SARS‐CoV‐2. Journal of cellular and molecular medicine. 2020 Aug;24(16):9478-82. https://doi.org/10.1111/jcmm.15607

21. Dou Q, Wei X, Zhou K, Yang S, Jia P. Cardiovascular manifestations and mechanisms in patients with COVID-19. Trends in Endocrinology & Metabolism. 2020 Dec 1;31(12):893-904. https://doi.org/10.1016/j.tem.2020.10.001

22. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA cardiology. 2020 Jul 1;5(7):831-40. https://doi.org/10.1001/jamacardio.2020.1286

23. Daviet F, Guilloux P, Hraiech S, Tonon D, Velly L, Bourenne J, Porto A, Gragueb-Chatti I, Bobot M, Baumstarck K, Papazian L. Impact of obesity on survival in COVID-19 ARDS patients receiving ECMO: results from an ambispective observational cohort. Annals of intensive care. 2021 Dec;11(1):1-0. https://doi.org/10.1186/s13613-021-00943-0

24. Kon ZN, Dahi S, Evans CF, Byrnes KA, Bittle GJ, Wehman B, Rector RP, McCormick BM, Herr DL, Sanchez PG, Pham SM, Griffith BP. Class III Obesity is Not a Contraindication to Venovenous Extracorporeal Membrane Oxygenation Support. Ann Thorac Surg. 2015;100(5):1855-60. https://doi.org/ 10.1016/j.athoracsur.2015.05.072.

25. Thomson RJ, Hunter J, Dutton J, Schneider J, Khosravi M, Casement A, Dhadwal K, Martin D. Clinical characteristics and outcomes of critically ill patients with COVID-19 admitted to an intensive care unit in London: A prospective observational cohort study. PloS one. 2020 Dec 15;15(12):e0243710. https://doi.org/10.1371/journal.pone.0243710

26. Moriconi D, Masi S, Rebelos E, Virdis A, Manca ML, De Marco S, Taddei S, Nannipieri M. Obesity prolongs the hospital stay in patients affected by COVID-19, and may impact on SARS-COV-2 shedding. Obesity research & clinical practice. 2020 May 1;14(3):205-9. https://doi.org/10.1016/j.orcp.2020.05.009

27. Wu SJ, Fan YF, Chien CY. Correlation between obesity, age and mortality for COVID-19 patients with acute respiratory distress syndrome supported by extracorporeal membrane oxygenation. Asian Journal of Surgery. 2023 Feb 8. https://doi.org/10.1016%2Fj.asjsur.2023.02.002

28. Halvatsiotis P, Kotanidou A, Tzannis K, Jahaj E, Magira E, Theodorakopoulou M, Konstandopoulou G, Gkeka E, Pourzitaki C, Kapravelos N, Papoti S. Demographic and clinical features of critically ill patients with COVID-19 in Greece: The burden of diabetes and obesity. Diabetes research and clinical practice. 2020 Aug 1;166:108331. https://doi.org/10.1016%2Fj.diabres.2020.108331

29. Boletim Epidemiológico no 100 - Boletim COE Coronavírus — Ministério da Saúde [Internet]. www.gov.br. [Acesso em 10 dez 2023]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/covid-19/2022/boletim-epidemiologico-no-100-boletim-coe-coronavirus.pdf/view

30. World Obesity Day Atlases | Obesity Atlas 2023 [Internet]. World Obesity Federation Global Obesity Observatory. 2023. [Acesso em 14 mar 2024]. Disponivel em: https://data.worldobesity.org/publications/?cat=19

31. Instituto Brasileiro de Geografia e Estatística - IBGE | Biblioteca | Detalhes | Pesquisa nacional de saúde: 2019: atenção primária à saúde e informações antropométricas: Brasil / IBGE, Coordenação de Trabalho e Rendimento, [Ministério da Saúde] [Internet]. biblioteca.ibge.gov.br. [Acesso em 17 dez 2023]. Disponível em : https://biblioteca.ibge.gov.br/index.php/biblioteca-catalogo?view=detalhes&id=2101758

32. Biddle SJ, Bengoechea García E, Pedisic Z, Bennie J, Vergeer I, Wiesner G. Screen time, other sedentary behaviours, and obesity risk in adults: a review of reviews. Current obesity reports. 2017 Jun;6:134-47. https://doi.org/10.1007/s13679-017-0256-9

33. Martí del Moral A, Calvo C, Martínez A. Ultra-processed food consumption and obesity-a systematic review. Nutricion Hospitalaria. 2021 Feb 1;38(1):177-85. https://doi.org/10.20960/nh.03151

Published

2025-05-21

How to Cite

1.
Machado da Silva e Silva K, Oliveira de Jesus J, Vitória Rocha ED, Silva DCG da. Risk factors associated with COVID-19 in obese patients treated at a hospital in Western Bahia. DEMETRA [Internet]. 2025 May 21 [cited 2025 Jun. 3];20:e83144. Available from: https://www.e-publicacoes.uerj.br/demetra/article/view/83144

Issue

Section

Clinical Nutrition

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