Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective?
Abstract Backgrounds To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. Methods Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-023-03937-8 |
| _version_ | 1797845770674634752 |
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| author | Julien Lagrandeur Pauline Putallaz Hélène Krief Christophe J. Büla Martial Coutaz |
| author_facet | Julien Lagrandeur Pauline Putallaz Hélène Krief Christophe J. Büla Martial Coutaz |
| author_sort | Julien Lagrandeur |
| collection | DOAJ |
| description | Abstract Backgrounds To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. Methods Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database. Results Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14–0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients. Conclusions In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated. |
| first_indexed | 2024-04-09T17:45:24Z |
| format | Article |
| id | doaj.art-c5e90c1f948c419694b2bceb3aaa28fb |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-09T17:45:24Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-c5e90c1f948c419694b2bceb3aaa28fb2023-04-16T11:24:27ZengBMCBMC Geriatrics1471-23182023-04-012311810.1186/s12877-023-03937-8Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective?Julien Lagrandeur0Pauline Putallaz1Hélène Krief2Christophe J. Büla3Martial Coutaz4Service of Geriatric Medicine, Hospital of ValaisService of Geriatric Medicine, Hospital of ValaisService of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of LausanneService of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital and University of LausanneService of Geriatric Medicine, Hospital of ValaisAbstract Backgrounds To investigate the relationship between obesity and 30-day mortality in a cohort of older hospitalized COVID-19 inpatients. Methods Included patients were aged 70 years or more; hospitalized in acute geriatric wards between March and December 2020; with a positive PCR for COVID-19; not candidate to intensive care unit admission. Clinical data were collected from patients electronic medical records. Data on 30-day mortality were retrieved from the hospital administrative database. Results Patients included (N = 294) were on average 83.4 ± 6.7 years old, 50.7% were women, and 21.7% were obese (BMI > 30 kg/m2). At 30-day, 85 (28.9%) patients were deceased. Compared to survivors in bivariable analysis, deceased patients were older (84.6 ± 7.6 vs 83.0 ± 6.3 years), more frequently with very complex health status (63.5% vs 39.7%, P < .001), but less frequently obese (13.4% vs 24.9%, P = .033) at admission. Over their stay, deceased patients more frequently (all P < .001) developed radiologic signs of COVID-19 (84.7% vs 58.9%), anorexia (84.7% vs 59.8%), hypernatremia (40.0% vs 10.5%), delirium (74.1% vs 30.1%), and need for oxygen (87.1% vs 46.4%) compared to survivors. In multivariable analysis that controlled for all markers of poor prognosis identified in bivariable analysis, obese patients remain with 64% (adjOR 0.36, 95%CI 0.14–0.95, P = .038) lower odds to be deceased at 30-day than non-obese patients. Conclusions In this population of older COVID-19 inpatients, an inverse association between obesity and 30-day mortality was observed even after adjusting for all already-known markers of poor prognosis. This result challenges previous observations in younger cohorts and would need to be replicated.https://doi.org/10.1186/s12877-023-03937-8COVID-19MortalityObesityOlder persons |
| spellingShingle | Julien Lagrandeur Pauline Putallaz Hélène Krief Christophe J. Büla Martial Coutaz Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? BMC Geriatrics COVID-19 Mortality Obesity Older persons |
| title | Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? |
| title_full | Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? |
| title_fullStr | Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? |
| title_full_unstemmed | Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? |
| title_short | Mortality in COVID-19 older patients hospitalized in a geriatric ward: Is obesity protective? |
| title_sort | mortality in covid 19 older patients hospitalized in a geriatric ward is obesity protective |
| topic | COVID-19 Mortality Obesity Older persons |
| url | https://doi.org/10.1186/s12877-023-03937-8 |
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