TY - JOUR
T1 - A higher BMI is not associated with a different immune response and disease course in critically ill COVID-19 patients
AU - Kooistra, Emma J.
AU - on behalf of the RCI-COVID-19 study group
AU - de Nooijer, Aline H.
AU - Claassen, Wout J.
AU - Grondman, Inge
AU - Janssen, Nico A. F.
AU - Netea, Mihai G.
AU - van de Veerdonk, Frank L.
AU - van der Hoeven, Johannes G.
AU - Kox, Matthijs
AU - Pickkers, Peter
AU - Hemelaar, Pleun
AU - Beunders, Remi
AU - Frenzel, Tim
AU - Schouten, Jeroen
AU - van der Velde, Sjef
AU - van der Eng, Hetty
AU - Roovers, Noortje
AU - Klop-Riehl, Margreet
AU - Gerretsen, Jelle
AU - Waalders, Nicole
AU - Heesakkers, Hidde
AU - van Schaik, Tirsa
AU - Buijsse, Leonie
AU - Joosten, Leo
AU - de Mast, Quirijn
AU - Jaeger, Martin
AU - Kouijzer, Ilse
AU - Dijkstra, Helga
AU - Lemmers, Heidi
AU - van Crevel, Reinout
AU - van de Maat, Josephine
AU - Nijman, Gerine
AU - Moorlag, Simone
AU - Taks, Esther
AU - Debisarun, Priya
AU - Wertheim, Heiman
AU - Hopman, Joost
AU - Rahamat-Langendoen, Janette
AU - Bleeker-Rovers, Chantal
AU - Koenen, Hans
AU - Fasse, Esther
AU - van Rijssen, Esther
AU - Kolkman, Manon
AU - van Cranenbroek, Bram
AU - Smeets, Ruben
AU - Joosten, Irma
N1 - Funding Information: Funding The study was internally funded by the participating departments. EJK was funded by a Radboudumc COVID-19 grant. MGN was supported by an ERC Advanced Grant (#833247) and a Spinoza Grant of the Netherlands Organization for Scientific Research. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature Limited. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Background/objectives: Obesity appears to be an independent risk factor for ICU admission and a severe disease course in COVID-19 patients. An aberrant inflammatory response and impaired respiratory function have been suggested as underlying mechanisms. We investigated whether obesity is associated with differences in inflammatory, respiratory, and clinical outcome parameters in critically ill COVID-19 patients. Subjects/methods: Sixty-seven COVID-19 ICU patients were divided into obese (BMI ≥ 30 kg/m 2, n = 18, 72% class I obesity, 28% class II obesity) and non-obese (BMI < 30 kg/m 2, n = 49) groups. Concentrations of circulating interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interferon gamma-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, and IL-1 receptor antagonist (RA) were determined from ICU admission until 10 days afterward, and routine laboratory and clinical parameters were collected. Results: BMI was 32.6 [31.2–34.5] and 26.0 [24.4–27.7] kg/m 2 in the obese and non-obese group, respectively. Apart from temperature, which was significantly lower in obese patients (38.1 [36.9–38.9] vs. 38.7 [38.0 −39.5] °C, p = 0.02), there were no between-group differences on ICU admission. Plasma cytokine concentrations declined over time (p < 0.05 for all), but no differences between obese and non-obese patients were observed. Also, BMI did not correlate with the cytokine response (IL-6 r = 0.09, p = 0.61, TNF-α r = 0.03, p = 0.99, IP-10 r = 0.28, p = 0.11). The kinetics of clinical inflammatory parameters and respiratory mechanics were also similar in both groups. Finally, no differences in time on ventilator, ICU length of stay or 40-day mortality between obese and non-obese patients were apparent. Conclusions: In COVID-19 patients requiring mechanical ventilation in the ICU, a higher BMI is not related to a different immunological response, unfavorable respiratory mechanics, or impaired outcome.
AB - Background/objectives: Obesity appears to be an independent risk factor for ICU admission and a severe disease course in COVID-19 patients. An aberrant inflammatory response and impaired respiratory function have been suggested as underlying mechanisms. We investigated whether obesity is associated with differences in inflammatory, respiratory, and clinical outcome parameters in critically ill COVID-19 patients. Subjects/methods: Sixty-seven COVID-19 ICU patients were divided into obese (BMI ≥ 30 kg/m 2, n = 18, 72% class I obesity, 28% class II obesity) and non-obese (BMI < 30 kg/m 2, n = 49) groups. Concentrations of circulating interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), interferon gamma-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, and IL-1 receptor antagonist (RA) were determined from ICU admission until 10 days afterward, and routine laboratory and clinical parameters were collected. Results: BMI was 32.6 [31.2–34.5] and 26.0 [24.4–27.7] kg/m 2 in the obese and non-obese group, respectively. Apart from temperature, which was significantly lower in obese patients (38.1 [36.9–38.9] vs. 38.7 [38.0 −39.5] °C, p = 0.02), there were no between-group differences on ICU admission. Plasma cytokine concentrations declined over time (p < 0.05 for all), but no differences between obese and non-obese patients were observed. Also, BMI did not correlate with the cytokine response (IL-6 r = 0.09, p = 0.61, TNF-α r = 0.03, p = 0.99, IP-10 r = 0.28, p = 0.11). The kinetics of clinical inflammatory parameters and respiratory mechanics were also similar in both groups. Finally, no differences in time on ventilator, ICU length of stay or 40-day mortality between obese and non-obese patients were apparent. Conclusions: In COVID-19 patients requiring mechanical ventilation in the ICU, a higher BMI is not related to a different immunological response, unfavorable respiratory mechanics, or impaired outcome.
UR - http://www.scopus.com/inward/record.url?scp=85099820639&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41366-021-00747-z
DO - https://doi.org/10.1038/s41366-021-00747-z
M3 - Article
C2 - 33495522
SN - 0307-0565
VL - 45
SP - 687
EP - 694
JO - International Journal of Obesity
JF - International Journal of Obesity
IS - 3
ER -