不同体重指数新型冠状病毒肺炎患者的临床特点及转归

目的探讨不同体重指数(BMI)新型冠状病毒肺炎(COVID-19)患者的临床特点及转归,为病情评估及预后提供依据。方法收集2020年1月16日至2020年3月28日在武汉科技大学附属孝感医院确诊的541例COVID-19患者临床资料,根据BMI分为正常体重组、超重组和肥胖组,比较3组患者的临床特点及转归。采用有序logistic回归分析BMI和临床分型的关联性。结果正常体重组有288例(53.23%),超重组193例(35.67%),肥胖组60例(11.09%)。与正常体重组比较,超重组、肥胖组合并高血压比例更高,实验室检查结果中白细胞、中性粒细胞、C反应蛋白、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸脱氢酶和三酰甘油更高,重症和危重症比例亦更高(P<0.05或P<0.01)。回归分析显示,校正年龄、性别和基础疾病后,BMI越高,临床分型越严重(OR=1.079,95%CI 1.010~1.154)。结论COVID-19患者中超重、肥胖患者更容易进展为重症和危重症,提示肥胖可能是影响COVID-19临床转归的重要危险因素。

Clinical characteristics and outcome of novel coronavirus pneumonia patients with different body mass index

Objective To investigate the clinical characteristics and outcome of novel coronavirus pneumonia(COVID-19)patients with different body mass index(BMI),and to provide the basis for disease assessment and prognosis.Methods The clinical data of 541 patients with COVID-19 diagnosed in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 16 to March 28,2020 were collected.The patients were divided into normal weight group,overweight group,and obesity group according to BMI.The clinical characteristics and outcomes of the three groups were compared.The correlation between BMI and clinical classification was analyzed by ordinal logistic regression.Results There were 288 cases(53.23%)in normal weight group,193 cases(35.67%)in overweight group,and 60 cases(11.09%)in obesity group.Compared with normal weight group,overweight and obesity groups displayed higher proportion of hypertension,with increased levels of white blood cells,neutrophils,C reactive protein,aspartate aminotransferase,alanine aminotransferase,lactate dehydrogenase,and triglyceride in laboratory test results,and higher proportion of severe and critical illness(P<0.05 or P<0.01).After adjusting for age,gender,and underlying diseases,regression analysis showed that higher BMI predicted more severe clinical classification(OR=1.079,95%CI 1.010-1.154).Conclusion In COVID-19 patients,overweight and obese patients are more likely to develop into severe and critical illness,suggesting that obesity may be an important risk factor affecting the clinical outcome of COVID-19.