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

Ibrahim Sahin; Cem Haymana; Tevfik Demir; Ibrahim Demirci; Ilker Tasci; Aysegul Atmaca; Erman Cakal; Naim Ata; Rifat Emral; Ugur Unluturk; Derun Ertugrul; Serpil Salman; Mustafa Sahin; Selcuk Dagdelen; Osman Celik; Murat Caglayan; Ilhan Satman; Alper Sonmez

doi:10.1055/a-1552-4449

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

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)

Authors

Ibrahim Sahin

¹Faculty of Medicine, Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
Cem Haymana

²Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
Tevfik Demir

³Faculty of Medicine, Department of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey
Ibrahim Demirci

²Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
Ilker Tasci

⁴Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
Aysegul Atmaca

⁵Faculty of Medicine, Department of Endocrinology and Metabolism, Ondokuz Mayis University, Samsun, Turkey
Erman Cakal

⁶Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
Naim Ata

⁷Department of Strategy Development, Ministry of Health, Ankara, Turkey
Rifat Emral

⁸Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey
Ugur Unluturk

⁹Faculty of Medicine, Department of Endocrinology and Metabolism, Hacettepe University, Ankara, Turkey
Derun Ertugrul

¹⁰Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
Serpil Salman

¹¹Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
Mustafa Sahin

¹¹Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
Selcuk Dagdelen

⁴Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
Osman Celik

¹²Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
Murat Caglayan

¹³Ankara Provincial Health Directorate, Ankara, Turkey
Ilhan Satman

¹⁴Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey

¹⁵The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey
Alper Sonmez

¹⁶Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey

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

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