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Exp Clin Endocrinol Diabetes 2022; 130(02): 115-124
DOI: 10.1055/a-1552-4449
Article

Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish Nationwide Cohort Study (TurCObesity)

Ibrahim Sahin
1   Faculty of Medicine, Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
,
Cem Haymana 
2   Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
,
Tevfik Demir
3   Faculty of Medicine, Department of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey
,
Ibrahim Demirci 
2   Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
,
Ilker Tasci 
4   Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
,
Aysegul Atmaca
5   Faculty of Medicine, Department of Endocrinology and Metabolism, Ondokuz Mayis University, Samsun, Turkey
,
Erman Cakal
6   Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
,
Naim Ata
7   Department of Strategy Development, Ministry of Health, Ankara, Turkey
,
Rifat Emral
8   Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey
,
Ugur Unluturk 
9   Faculty of Medicine, Department of Endocrinology and Metabolism, Hacettepe University, Ankara, Turkey
,
Derun Ertugrul
10   Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
,
Serpil Salman 
11   Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
,
Mustafa Sahin
11   Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
,
Selcuk Dagdelen
4   Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
,
Osman Celik
12   Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
,
Murat Caglayan
13   Ankara Provincial Health Directorate, Ankara, Turkey
,
Ilhan Satman
14   Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey
15   The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey
,
Alper Sonmez
16   Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
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Abstract

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.

Key words

Obesity - overweight - COVID-19 - morbidity - mortality


Publication History

Received: 13 June 2021
Received: 30 June 2021

Accepted: 13 July 2021

Article published online:
12 August 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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