OBESITY AND IN-HOSPITAL OUTCOMES AMONG PATIENTS WITH SEVERE COVID-19 IN VIET NAM

Abstract

Introduction: COVID-19 (Coronavirus disease 2019) is a global pandemic. Overweight and obesity are risk factors related to mortality as well as disease severity. Overweight and obesity are also increasing in Vietnam. Data related to the characteristics of COVID-19 in this vulnerable population was limited in Vietnam. The study was conducted (1) to describe the outcomes of overweight and obese COVID-19 patients, and (2) to investigate factors associated with the outcomes of overweight and obese COVID-19 patients. Methods: A cross-sectional description was conducted at the Hospital for Tropical Diseases from July 2021 to December 2021. Patients who were (1) ≥ 18 years old (2) diagnosed with COVID-19 with a positive RT-PCR SARS-CoV-2 result and (3) had BMI ≥ 23 kg/m2. Female pregnant women or ascites were excluded from this study. To determine factors associated with mortality and ICU admission, chi-square and Fisher's Exact were used. Variables with p < 0.05 were included in the logistic regression model to investigate independent risk factors. Cases directly admitted to the ICU were excluded when analyzing risk factors for ICU admission. Results: 173 patients were recruited (70 patients (40.46%) were overweight, 74 patients (42.77%) were obesity class I and 29 patients (16.76%) were obesity class II). The overall mortality rate was 28.9%. The ICU admission rate was 46.2% with a median ICU stay of 9 (6 – 15.25) days. The rate of respiratory support was 83.8%, of which 31.8% of patients required invasive mechanical ventilation and the median duration of respiratory support was 12 (6.5 – 16.5) days. Independently factors associated with ICU admission were diabetes (OR = 2.92 (1.27 – 6.67)) and a severe or critical condition at admission (OR = 8.82 (2.51 – 31.08). Independently factors associated with death were vaccination (OR = 0.23 (0.08 – 0.63)), a severe or critical at admission (OR = 15.74 (3.46 – 71.55)) and remdesivir usage (OR = 0.78 (0.16 – 0.87)). Recommendation: Vaccination against COVID-19 has been shown to be effective in the obese and overweight population.