Non-respiratory Complications and Obesity in Patients Dying with COVID-19 in Italy.

Onder, Graziano; Palmieri, Luigi; Vanacore, Nicola; Giuliano, Marina; Brusaferro, Silvio

OBJECTIVE To assess the impact of obesity on non-respiratory complications in patients dying with COVID-19. METHODS medical charts of 3,694 patients dying with COVID-19 in Italy were reviewed to extract information on demographics, pre-existing comorbidities, and in-hospital complications leading to death. Multivariate logistic regressions were performed to assess the association of obesity with non-respiratory complications. These analyses were adjusted for age, gender and number of pre-existing comorbidities. RESULTS obesity was present in 411/3,694 (11.1%) patients dying with COVID-19. Obesity was significantly associated with increased probability of experiencing acute renal failure (adjusted Odds Ratio: 1.33; 95% CI: 1.04-1.71) and shock (adjusted OR: 1.54; 95% CI: 1.19-1.99). The associations of obesity with acute renal failure and shock were stronger in patients aged < 60 years (adjusted OR: 2.00; 95% CI: 1.09-3.67 and OR: 2.37; 95% CI 1.29-4.36) than in those aged 60 years or older (adjusted OR: 1.20; 95% CI: 0.90-1.60 and OR: 1.22; 95% CI: 0.91-1.65). CONCLUSIONS In patients dying with COVID-19 in Italy, obesity is associated with an increased probability of non-respiratory complications, particularly shock and acute renal failure. These associations seem stronger in young than in older adults. Strategies should be put in place in COVID-19 patients with obesity to prevent these complications.