Clinical, Laboratory and Tomographic characteristics associated with obesity and BMI at Hospital admission in adult patients with COVID-19: a cross-sectional study

Main Article Content

Renato Sampaio Mello Neto
Marcos Henrique de Oliveira Morais
Pedro Jorge Luz Alves Cronemberger
Luan George Lima Xavier
Marta Alves Rosal
Maria do Carmo de Carvalho e Martins
https://orcid.org/0000-0002-9107-2485

Abstract

Introduction: The pathological status of obesity can influence COVID-19 from its initial clinical presentation, therefore, the identification of clinical and laboratory parameters most affected in the presence of obesity can contribute to improving the treatment of the disease. Objective: To identify the clinical, laboratory, and tomographic characteristics associated with obesity and BMI at t hospital admission in adult patients with COVID-19. Methods: This is a cross-sectional observational study with a total of 315 participants with COVID-19 confirmed by rt-PCR. The participants were divided into non-Obese (n=203) and Obese (n=112). Physical examinations, laboratory tests, and computed tomography of the chest were performed during the first 2 days of hospitalization. Results: Patients with obesity were younger, and they had higher systolic and diastolic blood pressure, higher frequency of alcoholism, fever, cough, and headache, higher ALT, LDH, and red blood cell count (RBC), hemoglobin, hematocrit, and percentage of lymphocytes. Also, they presented a lower value of leukocyte count and Neutrophil/Lymphocyte Ratio (RNL). The parameters positively correlated with BMI were alcoholism, systolic and diastolic blood pressure, fever, cough, sore throat, number of symptoms, ALT in men, LDH, magnesium, RBC, hemoglobin, hematocrit, and percentage of lymphocytes. The parameters negatively correlated with the BMI were: age and RNL. Conclusion: Several parameters were associated with obesity at hospital admission, revealing better than expected results. However, these results should be interpreted with great caution, as there may be some influence of a phenomenon called the Obesity Paradox that can distort the severity and prognosis of the patient.

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Mello Neto, R. S., Morais, M. H. de O., Cronemberger, P. J. L. A., Xavier, L. G. L., Rosal, M. A., & Martins, M. do C. de C. e. (2022). Clinical, Laboratory and Tomographic characteristics associated with obesity and BMI at Hospital admission in adult patients with COVID-19: a cross-sectional study. ABCS Health Sciences. https://doi.org/10.7322/abcshs.2021218.1933
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Original Articles

References

Meldrum DR, Morris MA, Gambone JC. Obesity pandemic: causes, consequences, and solutions-but do we have the will? Fertil Steril. 2017;107(4):833-9. https://doi.org/10.1016/j.fertnstert.2017.02.104

Whorl Health Organization (WHO). Obesity and overweight. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis. Vigitel Brasil 2019: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados brasileiros e no Distrito Federal em 2019. Brasília: Ministério da Saúde, 2020.

Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol. 2019;15:288-98. https://doi.org/10.1038/s41574-019-0176-8

Silva DT, Lima PSB, Mello Neto RS, Valente GM, Cabral DD, Marques NDS, et al. Obesity in SARS-COV-2 infection: literature review. Global J Res Analysis. 2021;10(3):19-23. https://doi.org/10.36106/gjra/27096

Sanchis-Gomar F, Lavie CJ, Mehra MR, Henry BM, Lippi G. Obesity and outcomes in COVID-19: when an epidemic and pandemic collide. Mayo Clin Proc. 2020;95(7):1445-53. https://doi.org/10.1016/j.mayocp.2020.05.006

Rychter AM, Zawada A, Ratajczak AE, Dobrowolska A, Krela‐Kaźmierczak I. Should patients with obesity be more afraid of COVID‐19? Obes Rev. 2020;21(9):e13083. https://doi.org/10.1111/obr.13083

Hussain A, Mahawar K, Xia Z, Yang W, EL-Hasani S. RETRACTED: Obesity and mortality of COVID-19. Meta-analysis. Obesity Res Clin Prac. 2020;14(4):295-300. https://doi.org/10.1016/j.orcp.2020.07.002

World Health Organization (WHO). Obesity: Preventing and managing the global epidemic: report of a WHO consultation. Available from: https://apps.who.int/iris/handle/10665/42330

Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, et al. Obesity in patients younger than 60 years is a risk factor for COVID-19 Hospital admission. Clin Infect Dis. 2020;71(15):896-897. https://doi.org/10.1093/cid/ciaa415

Klang E, Kassim G, Soffer S, Freeman R, Levin MA, Reich DL. Severe obesity as an independent risk factor for COVID-19 mortality in hospitalized patients younger than 50. Obesity. 2020;28(9):1595-9. https://doi.org/10.1002/oby.22913

Silva NJ, Ribeiro-Silva RC, Ferreira AJF, Teixeira CSS, Rocha AS, Alves FJO, et al. Combined association of obesity and other cardiometabolic diseases with severe COVID-19 outcomes: a nationwide cross-sectional study of 21 773 Brazilian adult and elderly inpatients. BMJ Open. 2021;11(8):e050739. https://doi.org/10.1136/bmjopen-2021-050739

Gonçalves DA, Ribeiro V, Gualberto A, Peres F, Luconi M, Gameiro J. Covid-19 and obesity: an epidemiologic analysis of the Brazilian data. Int J Endocrinol. 2021;2021:6667135. https://doi.org/10.1155/2021/6667135

Bilal B, Saleem F, Fatima SS. Alcohol consumption and obesity: The hidden scare with COVID-19 severity. Med Hypotheses. 2020;144:110272. https://doi.org/10.1016/j.mehy.2020.110272

Ghanemi A, Yoshioka M, St-Amand J. Will an obesity pandemic replace the coronavirus disease-2019 (COVID-19) pandemic? Med Hypotheses. 2020;144:110042. https://doi.org/10.1016/j.mehy.2020.110042

Whelton PK, Carey RM, Aronow WS, Casey Jr DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC/AHA/AAPA/ABC/ACPM /AGS/APhA/ASH /ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e13-115. https://doi.org/10.1161/HYP.0000000000000065

Ritter A, Kreis NN, Louwen F, Yuan J. Obesity and COVID-19: Molecular Mechanisms Linking Both Pandemics. Int J Mol Sci. 2020;21(16):5793. https://doi.org/10.3390/ijms21165793

Taing KY, Farkouh ME, Moineddin R, Tu JV, Jha P. Age and sex-specific associations of anthropometric measures of adiposity with blood pressure and hypertension in India: a cross-sectional study. BMC Cardiovasc Disord. 2016;16(1):247. https://doi.org/10.1186/s12872-016-0424-y

Whorl Health Organization (WHO). Coronavirus disease (COVID-19): How is it transmitted? Available from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19

Nilles EJ, Siddiqui SM, Fischinger S, Bartsch YC, Aubin MS, Zhou G, et al. Epidemiological and immunological features of obesity and SARS-CoV-2. medRxiv. 2020;2020.11.11.20229724. https://doi.org/10.1101/2020.11.11.20229724

Petrova D, Salamanca-Fernández E, Barranco MR, Pérez PN, Moleón JJJ, Sánchez MJ. La obesidad como factor de riesgo en personas con COVID-19: posibles mecanismos e implicaciones. Aten Primaria. 2020;52(7):496-500. https://doi.org/10.1016/j.aprim.2020.05.003

Hu X, Pan X, Zhou W, Gu X, Shen F, Yang B, et al. Clinical epidemiological analyses of overweight/obesity and abnormal liver function contributing to prolonged hospitalization in patients infected with COVID-19. Int J Obes (Lond). 2020;44(8):1784-9. https://doi.org/10.1038/s41366-020-0634-3

Kang Z, Luo S, Gui Y, Zhou H, Zhang Z, Tian C, et al. Obesity is a potential risk factor contributing to clinical manifestations of COVID-19. Int J Obes. 2020;44:2479-85. https://doi.org/10.1038/s41366-020-00677-2

Vidal-Cevallos P, Higuera-De-La-Tijera F, Chávez-Tapia NC, Sanchez-Giron F, Cerda-Reyes E, Rosales-Salyano VH, et al. Lactate-dehydrogenase associated with mortality in hospitalized patients with COVID-19 in Mexico: a multi-centre retrospective cohort study. Ann Hepatol. 2021;24:100338. https://doi.org/10.1016/j.aohep.2021.100338

Mostaghim A, Sinha P, Bielick C, Knudsen S, Beeram I, White LF, et al. Clinical outcomes and inflammatory marker levels in patients with Covid-19 and obesity at an inner-city safety net hospital. PLoS One. 2020;15(12):e0243888. https://doi.org/10.1371/journal.pone.0243888

Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID-19 – A systematic review. Life Sci. 2020;254:117788. https://doi.org/10.1016/j.lfs.2020.117788

Banach W, Nitschke K, Krajewska N, Mongiałło W, Matuszak O, Muszyński J, et al. The Association between Excess Body Mass and Disturbances in Somatic Mineral Levels. Int J Mol Sci. 2020;21(19):7306. https://doi.org/10.3390/ijms21197306

Takaya J, Higashino H, Kobayashi Y. Intracellular magnesium and insulin resistance. Magnes Res. 2004;17(2):126-36.

Purdy JC, Shatzel JJ. The hematologic consequences of obesity. Eur J Haematol. 2021;106(3):306-19. https://doi.org/10.1111/ejh.13560

Vuong J, Qiu Y, La M, Clarke G, Swinkels DW, Cembrowski G. Reference intervals of complete blood count constituents are highly correlated to waist circumference: Should obese patients have their own “normal values. Am J Hematol. 2014;89(7):671-7. https://doi.org/10.1002/ajh.23713

Lanini S, Montaldo C, Nicastri E, Vairo F, Agrati C, Petrosillo N, et al. COVID-19 disease-Temporal analyses of complete blood count parameters over course of illness, and relationship to patient demographics and management outcomes in survivors and non-survivors: A longitudinal descriptive cohort study. PLoS One. 2020;15(12):e0244129. https://doi.org/10.1371/journal.pone.0244129

Andersen CJ, Murphy KE, Fernandez ML. Impact of obesity and metabolic Syndrome on Immunity. Adv Nutr. 2016;7(1):66-75. https://doi.org/10.3945/an.115.010207

Furuncuoğlu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016;20(7):1300-6.

Green WD, Beck MA. Obesity altered T cell metabolism and the response to infection. Curr Opin Immunol. 2017;46:1-7. https://doi.org/10.1016/j.coi.2017.03.008

Beshbishy AM, Hetta HF, Hussein DE, Saati AA, Uba CC, Rivero-Perez N, et al. Factors associated with increased morbidity and mortality of obese and overweight COVID-19 patients. Biol. 2020;9(9):280. https://doi.org/10.3390/biology9090280

Zeng F, Li L, Zeng J, Deng Y, Huang H, Chen B, et al. Can we predict the severity of COVID-19 with a routine blood test? Pol Arch Intern Med. 2020;130(5):400-6. https://doi.org/10.20452/pamw.15331

Xiong Y, Sun D, Liu Y, Fan Y, Zhao L, Li X, et al. Clinical and high-resolution CT features of the COVID-19 infection: comparison of the initial and follow-up changes. Investig Radiol. 2020;55(6):332-9. https://doi.org/10.1097/RLI.0000000000000674

World Health Organization (WHO). Use of chest imaging in COVID-19: a rapid advice guide. Geneva: World Health Organization, 2020.

Hornung F, Rogal J, Loskill P, Löffler B, Deinhardt-Emmer S. The Inflammatory Profile of Obesity and the Role on Pulmonary Bacterial and Viral Infections. Int J Mol Sci. 2021;22(7):3456. https://doi.org/10.3390/ijms22073456