Obesity and its implications on cerebral circulation and intracranial compliance in severe COVID‐19

Brasil, Sérgio; Renck, Alessandra Covallero; Taccone, Fabio Silvio; Fontoura Solla, Davi Jorge; Tomazini, Bruno Martins; Wayhs, Sâmia Yasin; Fonseca, Sérgio; Bassi, Estevão; Lucena, Bruno; De Carvalho Nogueira, Ricardo; Paiva, Wellingson; Teixeira, Manoel Jacobsen; Frade Costa, Elaine Maria; Sá Malbouisson, Luiz Marcelo

OBJECTIVE: Multiple factors have been identified as causes of intracranial compliance impairment (ICCI) among patients with obesity. On the other hand, obesity has been linked with worst outcomes in COVID‐19. Thus, the hypothesis of severe acute respiratory syndrome (SARS) conducing to cerebral hemodynamic disorders (CHD) able to worsen ICCI and play an additional role on prognosis determination for COVID‐19 among obese patients becomes suitable. METHODS: 50 cases of SARS by COVID‐19 were evaluated, for the presence of ICCI and cerebrovascular circulatory disturbances in correspondence with whether unfavorable outcomes (death or impossibility for mechanical ventilation weaning [MVW]) within 7 days after evaluation. The objective was to observe whether obese patients (BMI ≥ 30) disclosed worse outcomes and tests results compared with lean subjects with same clinical background. RESULTS: 23 (46%) patients among 50 had obesity. ICCI was verified in 18 (78%) obese, whereas in 13 (48%) of 27 non‐obese (p = 0,029). CHD were not significantly different between groups, despite being high prevalent in both. 69% unfavorable outcomes were observed among obese and 44% for lean subjects (p = 0,075). CONCLUSION: In the present study, intracranial compliance impairment was significantly more observed among obese subjects and may have contributed for SARS COVID‐19 worsen prognosis.