Klang 2020.
Study characteristics | ||
Notes |
English title Severe obesity as an independent risk factor for COVID‐19 mortality in hospitalized patients younger than 50 Study setting Start of study recruitment (MM/YYYY): 03/2020 End of study recruitment (MM/YYYY): 05/2020 Study design: Registry data Study centre(s): Multiple centres/clinics/areas within a country Number of centres, clinics or areas: 5 Study setting: Inpatient Number of participants recruited: 572 (cohort 1), 2834 (cohort 2) Sampling method: Consecutive participants Participants Female participants (absolute number): 175 (cohort 1), 1270 (cohort 2) Age measure, value: NR Inclusion criteria: All adult patients who were positive for COVID‐19 by nasopharyngeal swab polymerase chain reaction test and were admitted to the hospital. Patients who were discharged or had died during the study period were included. Exclusion criteria: Patients who were still hospitalised at the time of analysis and patients with missing BMI data Smoking frequency: 76 (cohort 1), 717 (cohort 2) Diabetes frequency: 153 (cohort 1), 1446 (cohort 2) Hypertension frequency: 175 (cohort 1), 2124 (cohort 2) Cardiovascular disease frequency: 67 (cohort 1), 1190 (cohort 2) Asthma frequency: NR Chronic obstructive pulmonary disease frequency: NR Other pulmonary disease frequency: NR Immunosuppression frequency: NR Chronic kidney disease frequency: 70 (cohort 1), 597 (cohort 2) Cancer frequency: 39 (cohort 1), 491 (cohort 2) Steroid administration frequency: NR Supplemental oxygen administration frequency: 79 (cohort 1), 730 (cohort 2) Other treatments (frequency): NR Prognostic factor(s) Study’s definition for obesity: Obesity was defined as BMI ≥ 30 kg/m2; obesity groups included the following: BMI of 30 to < 40 and BMI ≥ 40 The time when obesity has been measured: Before disease or right at presentation Main variable used for determination of obesity: BMI Threshold used for definition: 30 Obesity frequency (absolute number): 275 (cohort 1), 956 (cohort 2) Prognostic factor(s): BMI of 30 to < 40 BMI ≥ 40 Outcome(s) Mortality Mechanical ventilation Outcome (prognostic factor) Mortality (BMI of 30 to < 40) (cohort 1) Follow‐up Number of patients followed completely for the outcome: 572 Number of obese patients followed completely for the outcome: 275 Number of non‐obese patients followed completely for the outcome: 297 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR, 0.313 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.1 (0.5, 2.3), 0.755 Outcome (prognostic factor) Mortality (BMI ≥ 40) (cohort 1) Follow‐up Number of patients followed completely for the outcome: 572 Number of obese patients followed completely for the outcome: 275 Number of non‐obese patients followed completely for the outcome: 297 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR, < 0.001 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 5.1 (2.3, 11.1), < 0.001 Outcome (prognostic factor) Mortality (BMI of 30 to < 40) (cohort 2) Follow‐up Number of patients followed completely for the outcome: 2834 Number of obese patients followed completely for the outcome: 956 Number of non‐obese patients followed completely for the outcome: 1878 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR, 0.117 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.1 (0.9, 1.3), 0.421 Outcome (prognostic factor) Mortality (BMI ≥ 40) (cohort 2) Follow‐up Number of patients followed completely for the outcome: 2834 Number of obese patients followed completely for the outcome: 956 Number of non‐obese patients followed completely for the outcome: 1878 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR, 0.532 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.6 (1.2, 2.3), 0.004 Outcome (prognostic factor) Mechanical ventilation (BMI of 30 to < 40) (cohort 1) Follow‐up Number of patients followed completely for the outcome: 572 Number of obese patients followed completely for the outcome: 275 Number of non‐obese patients followed completely for the outcome: 297 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.5 (0.8, 2.7), 0.2 Outcome (prognostic factor) Mechanical ventilation (BMI ≥ 40) (cohort 1) Follow‐up Number of patients followed completely for the outcome: 572 Number of obese patients followed completely for the outcome: 275 Number of non‐obese patients followed completely for the outcome: 297 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.5 (1.1, 2.1), 0.025 Outcome (prognostic factor) Mechanical ventilation (BMI of 30 to < 40) (cohort 2) Follow‐up Number of patients followed completely for the outcome: 2834 Number of obese patients followed completely for the outcome: 956 Number of non‐obese patients followed completely for the outcome: 1878 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.3 (1, 1.6), 0.016 Outcome (prognostic factor) Mechanical ventilation (BMI ≥ 40) (cohort 2) Follow‐up Number of patients followed completely for the outcome: 2834 Number of obese patients followed completely for the outcome: 956 Number of non‐obese patients followed completely for the outcome: 1878 Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age decile, male sex, CAD, CHF, HTN, DM, hyperlipidaemia, CKD, history of cancer, smoking (past or present), BMI 30‐40, BMI ≥ 40, and race Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.5 (1.1, 2.1), 0.025 |
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Item | Authors' judgement | Support for judgement |
Study Participation | Yes | Appendix 3 |
Study Attrition Mortality | No | Appendix 3 |
Study Attrition Mechanical ventilation | No | Appendix 3 |
Prognostic Factor Measurement | Yes | Appendix 3 |
Outcome Measurement Mortality | Yes | Appendix 3 |
Outcome Measurement Mechanical ventilation | Yes | Appendix 3 |
Confounding Bias Mortality | Yes | Appendix 3 |
Confounding Bias Mechanical ventilation | Yes | Appendix 3 |
Statistical Analysis Bias | Yes | Appendix 3 |