Obesity and Mortality of Critically Ill Patients With COVID-19

Study Overview
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Brief Summary
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Disproportionate impact of COVID-19 in patients with obesity is now well established. Obesity is associated with severe forms of COVID-19 and may be a risk factor of intensive care unit (ICU) admission. Obesity is associated with COVID-19 related hospital death in a large United Kingdom cohort study. However, there is a gap of knowledge on assessment of outcomes such as severity of Acute Respiratory Distress syndrome (ARDS), duration of hospitalisation and mortality in ICU. Moreover, an obesity survival paradox has been observed in patients with ARDS. This raises the question whether the obesity paradox has been broken by COVID-19. The investigators aim to explore risk factors of in-ICU death for patient with COVID-19, including obesity and other chronic diseases and to describe the clinical course and outcomes, including the management of acute respiratory failure and other intensive care management.

Detailed Description
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The investigators aim to report ICU mortality for patients according to BMI category and to describe the detailed ICU clinical course of illness : Risk factors for ICU mortality : age, sex, baseline comorbidities Causes of death Risk factors for use of non invasive mechanical ventilation Non-fatal outcomes Ventilator-free days ICU length of stay.

Official Title
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Obesity as a Risk Factor for Mortality of Critically Ill Patients With Coronavirus Disease 2019 (COVID-19): a Cohort Study of the First Wave in Nancy, France

Conditions
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COVID, Severe Acute Respiratory Syndrome, Obesity, Comorbidities and Coexisting Conditions

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patients with COVID-19 pneumonia admitted to ICUs between February 27th and April 18th 2020. Infection confirmed by reverse transcriptase polymerase chain reaction assay or radiologically by chest computed tomography scan Exclusion Criteria: No weight or height measurement available in the medical files

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Normal weight<br>BMI < 25 kg/m2 | |
| Overweight<br>BMI : 25 - 29.9 kg/m2 | |
| Moderate obesity<br>BMI : 30 - 39.9 kg/m2 | |
| Severe obesity<br>BMI : > or = 40 kg/m2 | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ICU mortality | number of fatal cases | through study completion, an average of 14 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Invasive mechanical ventilation | number of patients with invasive mechanical ventilation | through study completion, an average of 14 days | 
| In-hospital mortality | number of fatal cases | through study completion, an average of 21 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mortality, Covid-19, Invasive mechanical ventilation, Obesity, Acute Respiratory Distress syndrome, Intensive Care Unit, Critically ill patient