The utility of the Edmonton Obesity Staging System for the prediction of COVID-19 outcomes: a multi-centre study
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Published:2022-01-01
Issue:3
Volume:46
Page:661-668
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ISSN:0307-0565
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Container-title:International Journal of Obesity
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language:en
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Short-container-title:Int J Obes
Author:
Rodríguez-Flores Marcela, Goicochea-Turcott Eduardo W., Mancillas-Adame Leonardo, Garibay-Nieto Nayely, López-Cervantes Malaquías, Rojas-Russell Mario E., Castro-Porras Lilia V., Gutiérrez-León EduardoORCID, Campos-Calderón Luis F., Pedraza-Escudero Karen, Aguilar-Cuarto Karina, Villanueva-Ortega Eréndira, Hernández-Ruíz JoselinORCID, Guerrero-Avendaño Guadalupe, Monzalvo-Reyes Sheyla M., García-Rascón Rafael, Gil-Velázquez Israel N., Cortés-Hernández Dora E., Granados-Shiroma Marcela, Alvarez-Rodríguez Brenda G., Cabello-Garza Martha L.ORCID, González-Contreras Zaira L., Picazo-Palencia EstebanORCID, Cerda-Arteaga Juana M., Pérez-Gómez Héctor R., Calva-Rodríguez Roberto, Sánchez-Rodríguez Gerardo, Carpio-Vázquez Leslie D., Dávalos-Herrera María A., Villatoro-de-Pleitez Karla M., Suárez-López Melissa D., Nevárez-Carrillo María G., Pérez-Alcántara Karina, Mehta RoopaORCID, Diez Edurne Sandoval, Gregg Edward W.
Abstract
Abstract
Background
Patients with obesity have an increased risk for adverse COVID-19 outcomes. Body mass index (BMI) does not acknowledge the health burden associated this disease. The performance of the Edmonton Obesity Staging System (EOSS), a clinical classification tool that assesses obesity-related comorbidity, is compared with BMI, with respect to adverse COVID-19 outcomes.
Methods
1071 patients were evaluated in 11 COVID-19 hospitals in Mexico. Patients were classified into EOSS stages. Adjusted risk factors for COVID-19 outcomes were calculated and survival analysis for mechanical ventilation and death was carried out according to EOSS stage and BMI category.
Results
The risk for intubation was higher in patients with EOSS stages 2 and 4 (HR 1.42, 95% CI 1.02–1.97 and 2.78, 95% CI 1.83–4.24), and in patients with BMI classes II and III (HR 1.71, 95% CI 1.06–2.74, and 2.62, 95% CI 1.65–4.17). Mortality rates were significantly lower in patients with EOSS stages 0 and 1 (HR 0.62, 95% CI 0.42–0.92) and higher in patients with BMI class III (HR 1.58, 95% CI 1.03–2.42). In patients with a BMI ≥ 25 kg/m2, the risk for intubation increased with progressive EOSS stages. Only individuals in BMI class III showed an increased risk for intubation (HR 2.24, 95% CI 1.50–3.34). Mortality risk was increased in EOSS stages 2 and 4 compared to EOSS 0 and 1, and in patients with BMI class II and III, compared to patients with overweight.
Conclusions
EOSS was associated with adverse COVID-19 outcomes, and it distinguished risks beyond BMI. Patients with overweight and obesity in EOSS stages 0 and 1 had a lower risk than patients with normal weight. BMI does not adequately reflect adipose tissue-associated disease, it is not ideal for guiding chronic-disease management.
Publisher
Springer Science and Business Media LLC
Subject
Nutrition and Dietetics,Endocrinology, Diabetes and Metabolism,Medicine (miscellaneous)
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