The impact of BMI on the course of the acute SARS-COV-2 infection and the risks that emerge during the first year after the hospital discharge. Subanalysis evidence of the AKTIV and AKTIV 2 registries-Reference-Cited by-同舟云学术

The impact of BMI on the course of the acute SARS-COV-2 infection and the risks that emerge during the first year after the hospital discharge. Subanalysis evidence of the AKTIV and AKTIV 2 registries

Published:2023-01-24 Issue:6 Volume:68 Page:89-109
ISSN:2308-1430
Container-title:Problems of Endocrinology
language:
Short-container-title:Probl Endokrinol (Mosk)

Author:

Arutyunov A. G.¹^ORCID,Tarlovskaya E. I.²^ORCID,Galstyan G. R.³^ORCID,Batluk T. I.⁴^ORCID,Bashkinov R. A.⁵^ORCID,Arutyunov G. P.⁴^ORCID,Belenkov Yu. N.⁶^ORCID,Konradi A. O.⁷^ORCID,Lopatin Yu. M.⁸^ORCID,Rebrov A. P.⁹^ORCID,Tereshchenko S. N.¹⁰^ORCID,Chesnikova A. I.¹¹^ORCID,Hayrapetyan H. G.¹²^ORCID,Babin A. P.¹³,Bakulin I. G.¹⁴^ORCID,Bakulina N. V.¹⁴^ORCID,Balykova L. A.¹⁵^ORCID,Blagonravova A. S.¹⁶^ORCID,Boldina M. V.¹⁶^ORCID,Butomo M. I.¹⁷^ORCID,Vaisberg A. R.¹⁶^ORCID,Galyavich A. S.¹⁸^ORCID,Gomonova V. V.¹⁴^ORCID,Grigoryeva N. Yu.¹⁹^ORCID,Gubareva I. V.²⁰^ORCID,Demko I. V.²¹^ORCID,Evzerikhina A. V.²²,Zharkov A. V.²³^ORCID,Zateishchikova A. A.²⁴^ORCID,Kamilova U. K.²⁵^ORCID,Kim Z. F.²⁶^ORCID,Kuznetsova T. Yu.²⁷^ORCID,Kulikov A. N.¹⁷^ORCID,Lareva N. V.²⁸^ORCID,Makarova E. V.¹⁶^ORCID,Malchikova S. V.²⁹^ORCID,Nedogoda S. V.⁸^ORCID,Petrova M. M.³⁰^ORCID,Pochinka I. G.³¹^ORCID,Protasov K. V.³²^ORCID,Protsenko D. N.³³^ORCID,Ruzanov D. Yu.³⁴^ORCID,Saiganov S. A.¹⁴^ORCID,Sarybaev A. Sh.³⁵^ORCID,Selezneva N. M.¹⁵^ORCID,Sugraliev A. B.³⁶^ORCID,Fomin I. V.¹⁶^ORCID,Khlynova O. V.³⁷^ORCID,Chizhova O. Yu.¹⁴^ORCID,Shaposhnik I. I.³⁸^ORCID,Schukarev D. A.²³,Abdrakhmanova A. K.³⁹^ORCID,Avetisyan S. A.⁴⁰,Avoyan H. G.¹²^ORCID,Azaryan K. K.¹²,Aimakhanova G. T.³⁶,Ayypova D. A.³⁵,Akunov A. Ch.³⁵,Alieva M. K.¹⁴^ORCID,Almukhambedova A. R.⁴¹^ORCID,Aparkina A. V.⁹^ORCID,Aruslanova O. R.⁴²^ORCID,Ashina E. Yu.¹⁶^ORCID,Badina O. Yu.⁴³^ORCID,Barysheva O. Yu.²⁷^ORCID,Batchaeva A. S.⁴⁴,Bitieva A. M.¹⁴^ORCID,Bikhteev I. U.¹⁴^ORCID,Borodulina N. A.⁴²^ORCID,Bragin M. V.¹⁴^ORCID,Brazhnik V. A.²⁴,Budu A. M.⁴⁵,Bykova G. A.³⁷^ORCID,Vagapova K. R.⁴⁶,Varlamova D. D.²⁷^ORCID,Vezikova N. N.²⁷^ORCID,Verbitskaya E. A.⁴⁷^ORCID,Vilkova O. E.¹⁹^ORCID,Vinnikova E. A.¹⁴^ORCID,Vustina V. V.⁴⁸^ORCID,Galova E. A.¹⁶^ORCID,Genkel V. V.³⁸^ORCID,Giller D. B.⁶^ORCID,Gorshenina E. I.¹⁵,Grigoryeva E. V.⁹^ORCID,Gubareva E. Yu.²⁰^ORCID,Dabylova G. M.³⁶,Demchenko A. I.²⁰,Dolgikh O. Yu.⁴⁹,Duishobaev M. Y.³⁵,Evdokimov D. S.¹⁴^ORCID,Egorova K. E.⁵⁰^ORCID,Ermilova A. N.⁵¹^ORCID,Zheldybaeva A. E.³⁶,Zarechnova N. V.⁴³,Zimina Yu. D.⁵²^ORCID,Ivanova S. Yu.⁵³^ORCID,Ivanchenko E. Yu.¹⁶^ORCID,Ilina M. V.²³^ORCID,Kazakovtseva M. V.²⁹^ORCID,Kazymova E. V.⁵⁴,Kalinina Yu. S.³⁰^ORCID,Kamardina N. A.⁴³,Karachenova A. M.²⁸^ORCID,Karetnikov I. A.⁵⁵^ORCID,Karoli N. A.⁹^ORCID,Karsiev M. Kh.¹⁴^ORCID,Kaskaeva D. S.³⁰^ORCID,Kasymova K. F.³⁰^ORCID,Kerimbekova Zh. B.³⁵,Kim E. S.²⁶,Kiseleva N. V.⁵⁶^ORCID,Klimenko D. A.²⁰,Klimova A. V.⁵⁷^ORCID,Kovalishena O. V.¹⁶^ORCID,Kozlov S. V.²⁴,Kolmakova E. V.¹⁴,Kolchinskaya T. P.⁵⁸,Kolyadich M. I.⁵⁹^ORCID,Kondryakova O. V.²⁰^ORCID,Konoval M. P.¹⁴^ORCID,Konstantinov D. Yu.²⁰^ORCID,Konstantinova E. A.²⁰^ORCID,Kordyukova V. A.¹⁶,Koroleva E. V.⁶⁰,Kraposhina A. Yu.²¹^ORCID,Kryukova T. V.⁶¹,Kuznetsova A. S.³⁸^ORCID,Kuzmina T. Yu.³⁰^ORCID,Kuzmichev K. V.⁶²,Kulchoroeva Ch. K.³⁵^ORCID,Kuprina T. V.²⁷^ORCID,Kuranova I. M.⁶³,Kurenkova L. V.⁶⁴,Kurchugina N. Yu.²⁰^ORCID,Kushubakova N. A.³⁵^ORCID,Levankova V. I.⁶⁵^ORCID,Ledyaeva A. A.⁸^ORCID,Lisun T. V.⁶⁶^ORCID,Lisyanskaya V. E.¹⁷,Lyubavina N. A.¹⁶^ORCID,Magdeeva N. A.⁹^ORCID,Mazalov K. V.⁴³,Mayseenko V. I.³⁴^ORCID,Makarova A. S.³²^ORCID,Maripov A. M.³⁵^ORCID,Markov N. V.¹⁷^ORCID,Marusina A. A.²³^ORCID,Melnikov E. S.⁵^ORCID,Metlinskaya A. I.¹⁷^ORCID,Moiseenko N. B.¹⁹^ORCID,Muradova F. N.¹⁶^ORCID,Muradyan R. G.⁶⁷,Musaelyan Sh. N.⁴⁰,Nekaeva E. S.¹⁶^ORCID,Nikitina N. M.⁹^ORCID,Nifontov S. E.¹⁷^ORCID,Obolentseva E. Yu.¹⁷^ORCID,Obukhova A. A.¹⁷^ORCID,Ogurlieva B. B.⁶⁸,Odegova A. A.²⁹^ORCID,Omarova Yu. V.¹⁶^ORCID,Omurzakova N. A.³⁵^ORCID,Ospanova Sh. O.³⁶,Pavlova V. A.¹⁷^ORCID,Pakhomova E. V.⁶⁹^ORCID,Petrov L. D.⁷⁰,Plastinina S. S.¹⁶^ORCID,Platonov D. A.²⁴^ORCID,Pogrebetskaya V. A.⁷¹,Polyakov D. V.⁴⁴^ORCID,Polyakov D. S.¹⁶^ORCID,Ponomarenko E. V.⁷²,Popova L. L.²⁰^ORCID,Potanin A. A.¹⁷^ORCID,Prokofieva N. A.¹⁴^ORCID,Rabik Yu. D.¹⁷,Rakov N. A.¹⁶,Rakhimov A. N.²⁵,Rozanova N. A.²²,Samus I. V.⁷³^ORCID,Serikbolkyzy S.³⁶,Sidorkina Ya. A.²⁴,Simonov A. A.¹⁴^ORCID,Skachkova V. V.⁴⁸^ORCID,Skvortsova R. D.¹⁷^ORCID,Skuridin D. S.¹⁷^ORCID,Solovieva D. V.¹⁹^ORCID,Solovieva I. A.²¹^ORCID,Sukhomlinova I. M.⁷⁴,Sushilova A. G.¹⁴^ORCID,Tagaeva D. R.²⁵,Titoykina Yu. V.¹⁵^ORCID,Tikhonova E. P.³⁰^ORCID,Tokmin D. S.⁷⁵,Tolmacheva A. A.⁷⁶^ORCID,Torgunakova M. S.³⁰^ORCID,Trenogina K. V.⁴⁸^ORCID,Trostyanetskaya N. A.¹⁴,Trofimov D. A.⁷⁷^ORCID,Trubnikova M. A.⁷⁸^ORCID,Tulichev A. A.⁷⁹^ORCID,Tursunova A. T.³⁶,Ulanova N. D.⁶²^ORCID,Fatenkov O. V.²⁰^ORCID,Fedorishina O. V.³²^ORCID,Fil T. S.¹⁴^ORCID,Fomina I. Yu.⁸⁰,Fominova I. S.⁸¹,Frolova I. A.⁴³^ORCID,Tsvinger S. M.²⁸^ORCID,Tsoma V. V.⁸^ORCID,Cholponbaeva M. B.³⁵,Chudinovskikh T. I.²⁹^ORCID,Shavrin I. V.⁸²^ORCID,Shevchenko O. A.⁸³,Shikhaliev D. R.¹⁷^ORCID,Shishkina E. A.³⁷^ORCID,Shishkov K. Yu.²⁰^ORCID,Shcherbakov S. Yu.⁸⁴,Shcherbakova G. V.⁶^ORCID,Yausheva E. A.⁵⁴

Affiliation:

1. Association «Eurasian Association of Therapists»; National Institute of Health named after S. Avdalbekyan

2. Association «Eurasian Association of Therapists»; Privolzhsky Research Medical University

3. Scientific Medical Research Center of Endocrinology of the Ministry of Health of Russia

4. Association «Eurasian Association of Therapists»; Pirogov Russian National Research Medical University

5. Association «Eurasian Association of Therapists»; North-Western State Medical University named after I.I. Mechnikov

6. Sechenov University

7. Almazov National Medical Research Centre” of the Ministry of Health of the Russian Federation

8. Volgograd State Medical University

9. Saratov State Medical University named after V.I. Razumovsky

10. National medical research center of cardiology

11. Rostov State Medical University

12. Erebouni Cardiology Center

13. Nicolae Testemitanu State University of Medicine and Pharmacy

14. North-Western State Medical University named after I.I. Mechnikov

15. Ogarev Mordovia State University

16. Privolzhsky Research Medical University

17. Pavlov First State Medical University of St. Petersburg

18. The Republican Center for Cardiovascular Diseases of State Autonomous Institution of Health «Interregional Clinical Diagnostic Center»; Kazan State Medical University

19. National Research Lobachevsky State University of Nizhni Novgorod

20. Samara State Medical University, Internal Diseases Department

21. Krasnoyarsk state medical University named after Professor V. F. Voino-Yasenetsky; Regional state budgetary healthcare institution «Regional Clinical Hospital»

22. Krasnogorsk city hospital №1

23. Kirovsk Interdistrict Hospital

24. City Hospital №51

25. The Republican Specialized Scientific and Practical Medical Center for Therapy and Medical Rehabilitation

26. Medical Center «GAUZ GKB №7»

27. Petrozavodsk State University

28. Chita State Medical Academy

29. Kirov State Medical University

30. Krasnoyarsk state medical University named after Professor V. F. Voino-Yasenetsky

31. Privolzhsky Research Medical University; Privolzhsky Research Medical University, City Clinical Hospital №13 of Nizhniy Novgorod

32. Irkutsk State Medical Academy of Postgraduate Education

33. Pirogov Russian National Research Medical University; Moscow City Clinical Hospital №40

34. Educational Institution «Gomel State Medical University»

35. National Center of Cardiology and Internal Medicine named after prof. M. Mirrakhimov

36. Asfendiyarov Kazakh National Medical University

37. Perm State Medical University named after E.A. Vagner

38. South-Ural State Medical University

39. Kazakh University of Continuing Education; Clinical Infectious Diseases Hospital named after I. Zhekenovа

40. Yerevan State Medical University

41. Central Clinical Hospital of the Office of the President of RF

42. Perm Regional Clinical Cardiological Dispensary

43. The Volga District Medical Centre, Federal Medical and Biological Agency of Russia

44. Pirogov Russian National Research Medical University

45. Clinical City Hospital №1

46. FSBI “Polyclinic №1 of the Administrative Directorate of the President of the Russian Federation

47. Regional state budgetary healthcare institution «Regional Clinical Hospital»

48. Perm Regional Clinical Hospital

49. State Budgetary Institution of Healthcare of the Samara Region «Chapaevskaya Central City Hospital», Chapaevsk

50. Republic hospital n.a. V.A. Baranov

51. Association «Eurasian Association of Therapists»; «Empathy» (mental health centre)

52. City Clinical Hospital №25

53. State Budgetary Medical Institution Republic of Karelia Hospital for Veterans

54. Private Healthcare Institution «Clinical Hospital RZHD Meditsyna at Samara railway station»

55. Irkutsk regional clinical hospital of Conferred Order of Merit

56. Nizhniy Novgorod City Hospital №40

57. Pirogov Russian National Research Medical University; Moscow City State Outpatient Hospital №134

58. Municipal Autonomous Healthcare Institution of the Order of the Red Banner of Labour «City Clinical Hospital №1»

59. South-Ural State Medical University; Municipal Autonomous Healthcare Institution of the Order of the Red Banner of Labour «City Clinical Hospital №1»

60. National Research Lobachevsky State University of Nizhni Novgorod; City clinical hospital №5 of Nizhniy Novgorod, National Research Lobachevsky State University of Nizhni Novgorod

61. Association «Eurasian Association of Therapists»

62. Privolzhsky Research Medical University, City Clinical Hospital №13 of Nizhniy Novgorod

63. Gorodetskaya Central City Hospital of Nizhniy Novgorod Region

64. Republic hospital n.a. S.V. Katkov

65. Petrozavodsk City polyclinic №1

66. Moscow City Clinical Hospital №40

67. Global Medical System clinics and hospitals

68. Pirogov Russian National Research Medical University; Moscow City Clinical Hospital №4

69. GBUZ RK «Republican tuberculosis dispensary»

70. Health Center of Briceni

71. SBHI of Nizhniy Novgorod Region «City Clinical Hospital №38»

72. Medical center «Zimamed»

73. Kemerovo regional clinical psychiatric hospital

74. Saint-Petersburg hospital for veterans

75. Labs of the Future

76. Novosibirsk State Medical University; SBHCI of Novosibirsk region «Clinical Polyclinic №3»

77. Kazan State Medical University; Medical Center «GAUZ GKB №7»

78. Association «Eurasian Association of Therapists»; LLC “Fresenius Medical Care Kuban”

79. Privolzhsky Research Medical University; SBHI of Nizhniy Novgorod region City Clinical Hospital №3

80. Privolzhsky Research Medical University; SBHI of Nizhniy Novgorod region City Outpatient Hospital №1

81. Republic of Mordovia Clinical Hospital №4

82. Medsi

83. SBHI of Samara Region «Samara City Polyclinic №3»

84. Kazan State Medical Academy

Abstract

BACKGROUND. There is enough evidence of the negative impact of excess weight on the formation and progression of res piratory pathology. Given the continuing SARS-CoV-2 pandemic, it is relevant to determine the relationship between body mass index (BMI) and the clinical features of the novel coronavirus infection (NCI).AIM. To study the effect of BMI on the course of the acute SARS-COV-2 infection and the post-covid period.MATERIALS AND METHODS. AKTIV and AKTIV 2 are multicenter non-interventional real-world registers. The АКТИВ registry (n=6396) includes non-overlapping outpatient and inpatient arms with 6 visits in each. The АКТИВ 2 registry (n=2968) collected the data of hospitalized patients and included 3 visits. All subjects were divided into 3 groups: not overweight (n=2139), overweight (n=2931) and obese (n=2666).RESULTS. A higher BMI was significantly associated with a more severe course of the infection in the form of acute kidney injury (p=0.018), cytokine storm (p<0.001), serum C-reactive protein over 100 mg/l (p<0.001), and the need for targeted therapy (p<0.001) in the hospitalized patients. Obesity increased the odds of myocarditis by 1,84 times (95% confidence interval [CI]: 1,13–3,00) and the need for anticytokine therapy by 1,7 times (95% CI: 1,30–2,30).The patients with the 1st and 2nd degree obesity, undergoing the inpatient treatment, tended to have a higher probability of a mortality rate. While in case of morbid obesity patients this tendency is the most significant (odds ratio — 1,78; 95% CI: 1,13-2,70). At the same time, the patients whose chronical diseases first appeared after the convalescence period, and those who had certain complaints missing before SARS-CoV-2 infection, more often had BMI of more than 30 kg/m2 (p<0,001).Additionally, the odds of death increased by 2,23 times (95% CI: 1,05-4,72) within 3 months after recovery in obese people over the age of 60 yearsCONCLUSION. Overweight and/or obesity is a significant risk factor for severe course of the new coronavirus infection and the associated cardiovascular and kidney damage Overweight people and patients with the 1st and 2nd degree obesity tend to have a high risk of death of SARS-CoV-2 infection in both acute and post-covid periods. On top of that, in case of morbid obesity patients this tendency is statistically significant. Normalization of body weight is a strategic objective of modern medicine and can contribute to prevention of respiratory conditions, severe course and complications of the new coronavirus infection.

Publisher

Endocrinology Research Centre

Subject

Endocrinology, Diabetes and Metabolism

Reference42 articles.

1. Dedov II, Mokrysheva NG, Mel’nichenko GA, et al. Obesity. Clinical guidelines. Consilium Medicum. 2021;23(4):311-325. (In Russ.). doi: https://doi.org/10.26442/20751753.2021.4.200832.

2. gks.ru/free_doc/new_site/ food18/index.html [Internet]. Federal’naya sluzhba gosudarstvennoj statistiki. Vyborochnoe nablyudenie raciona pitaniya naseleniya (2018 g.). Statisticheskie tablicy; Rossijskaya Federaciya (in Russ.). Доступно по: https://rosstat.gov.ru/storage/mediabank/Racion.pdf. Ссылка активна на 30.08.2022.

3. Guh DP, Zhang W, Bansback N, et al. The incidence of comorbidities related to obesity and overweight: A systematic review and meta-analysis. BMC Public Health. 2009;9(1):88. doi: https://doi.org/10.1186/1471-2458-9-88

4. Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med. 2018;12(9):755-767. doi: https://doi.org/10.1080/17476348.2018.1506331.

5. Zuin M, Rigatelli G, Zuliani G, et al. Arterial hypertension and risk of death in patients with COVID-19 infection: Systematic review and meta-analysis. J Infect. 2020;81(1):e84-e86. doi: https://doi.org/10.1016/j.jinf.2020.03.059