It has been demonstrated that obesity is an independent risk factor for worse outcomes in patients with COVID-19. Our objectives were to investigate which classes of obesity are associated with higher in-hospital mortality and to assess the association between obesity and systemic inflammation. This was a retrospective study which included consecutive hospitalized patients with COVID-19 in a tertiary center. Three thousand five hundred thirty patients were included in this analysis (female sex: 1579, median age: 65 years). The median body mass index (BMI) was 28.8 kg/m². In the overall cohort, a J-shaped association between BMI and in-hospital mortality was depicted. In the subgroup of men, BMI 35–39.9 kg/m² and BMI ≥40 kg/m² were found to have significant association with higher in-hospital mortality, while only BMI ≥40 kg/m² was found significant in the subgroup of women. No significant association between BMI and IL-6 was noted. Obesity classes II and III in men and obesity class III in women were independently associated with higher in-hospital mortality in patients with COVID-19. The male population with severe obesity was the one that mainly drove this association. No significant association between BMI and IL-6 was noted.

已经证明，肥胖是导致 COVID-19 患者预后更差的独立危险因素。我们的目标是调查哪些类型的肥胖与较高的住院死亡率相关，并评估肥胖与全身炎症之间的关联。这是一项回顾性研究，其中包括在一家三级中心连续住院的 COVID-19 患者。该分析包括 3530 名患者（女性：1579，中位年龄：65 岁）。中位体重指数 (BMI) 为 28.8 kg/m ²。在整个队列中，描述了 BMI 与住院死亡率之间的 J 型关联。在男性亚组中，BMI 35–39.9 kg/m ²和 BMI ≥40 kg/m ²发现与较高的住院死亡率显着相关，而仅发现 BMI ≥ 40 kg/m ²在女性亚组中显着。BMI 和 IL-6 之间没有显着关联。男性肥胖 II 级和 III 级以及女性肥胖 III 级与 COVID-19 患者较高的住院死亡率独立相关。严重肥胖的男性人群是主要推动这种关联的人群。BMI 和 IL-6 之间没有显着关联。