Purpose While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19), factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of COVID-19 patients who were overweight or obese and variables associated with severe disease in a large group of consecutive cases. Methods A nationwide retrospective cohort study was performed using the Turkish National Healthcare Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients registered between March 11 and May 30, 2020, were recorded. Results A total of 14, 625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight (34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission, intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04–3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02–1.05; p<0.001) were associated with a higher intubation/mechanical ventilation rate but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40–4.67; p=0.002). Old age, male gender, chronic kidney disease, and high C reactive protein levels were independently associated with COVID-19 mortality in overweight or obese patients. Conclusions COVID-19 patients who were overweight or obese were more likely to have adverse outcomes but only obesity was a predictor of mortality. Such patients should receive urgent medical attention and active management, especially the elderly, men, and people with chronic kidney disease.

中文翻译：

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COVID-19 超重和肥胖患者的临床特征和结果：土耳其全国队列研究 (TurCObesity)

目的虽然肥胖与 2019 年冠状病毒病 (COVID-19) 的更严重后果有关，但导致预后不良的因素仍不清楚。本研究在大量连续病例中评估了超重或肥胖的 COVID-19 患者的结果以及与严重疾病相关的变量。方法 使用土耳其国家医疗保健数据库进行了一项全国性回顾性队列研究。记录了 2020 年 3 月 11 日至 5 月 30 日期间登记的患者的人口学特征、实验室检查、合并症和药物治疗。结果共纳入体重正常（34.7%）、超重（35.6%）、肥胖（29.7%）的患者14、625例（中位年龄：42岁，IQR：26岁；女性57.4%）。住院、ICU入院、插管/机械通气、肺部受累、超重或肥胖患者的死亡率明显更高。在调整后的分析中，超重（OR，95% CI：1.82，1.04-3.21；p=0.037）和肥胖（OR，95% CI：2.69，1.02-1.05；p<0.001）均与较高的插管/机械通气率，但只有肥胖与死亡率增加相关（OR，95% CI：2.56，1.40-4.67；p=0.002）。高龄、男性、慢性肾病和高 C 反应蛋白水平与超重或肥胖患者的 COVID-19 死亡率独立相关。结论 超重或肥胖的 COVID-19 患者更有可能出现不良后果，但只有肥胖是死亡率的预测因素。此类患者应接受紧急医疗护理和积极管理，尤其是老年人、男性和慢性肾病患者。