Covid-19 e obesidade : uma revisão sistemática e um estudo transversal retrospectivo

Abstract

Obesity, a chronic endocrine-metabolic disease characterized by the accumulation of adipose tissue and chronic low-grade inflammation, contributes to the development of various diseases and a poorer clinical prognosis. COVID-19 is a disease caused by the SARS-CoV-2 coronavirus that has resulted in a pandemic with significant worldwide impact. Studies have shown that factors such as obesity, age, presence of non-communicable chronic diseases (NCDs), contribute to the development of severe forms of COVID-19 and increase the need for hospitalization in the Intensive Care Unit (ICU). Therefore, the aim of this study was to conduct a systematic review and a retrospective cross-sectional study to assess the influence of obesity on hospitalized patients with COVID-19. A systematic literature review was conducted using PRISMA criteria to evaluate the incidence of complications and death rates in obese and nonobese patients hospitalized with COVID-19. A total of 395 articles were analyzed, and 49 were selected for the final review. Several articles described that overweight and obesity are associated with longer hospital stays and other severe outcomes of COVID-19, such as invasive mechanical ventilation, renal, pulmonary, hepatic, and cardiac injuries, septic shock, and death. The retrospective cross-sectional study was conducted using data collected from medical records of patients diagnosed with COVID-19 and hospitalized between March 23, 2020, and March 31, 2021, at the Jorge de Abreu Regional Hospital (HRJA) in Sinop-MT. The study aimed to evaluate the prevalence and influence of obesity in this population sample. The patient data were initially divided into two groups: those hospitalized in the ward and the ICU. Subsequently, the data were subdivided into eutrophic, overweight, and obese categories. The data were tabulated and analyzed using descriptive and quantitative analyses, with the results expressed as mean ± SD or percentage (%), using Student's t-tests, one-way ANOVA, or chisquare tests. Data from 399 ward patients and 389 ICU patients were evaluated. In both groups, the majority were male, married, and of white ethnicity. The overall mean length of hospital stay, age, weight, and BMI were significantly higher in ICU patients compared to ward patients. Additionally, ICU patients had a higher prevalence of obesity, diabetes, cardiovascular diseases, and other NCDs. 82.2% of ICU patients and 18.8% of ward patients required assisted mechanical ventilation. The mortality rate was significantly higher in ICU patients (75.2%) compared to ward patients (13.9%). Furthermore, it was observed that both in the ward and ICU, overweight and obesity significantly increased the need for mechanical ventilation, incidence of complications, and mortality. Therefore, it can be concluded that the clinical condition of COVID-19 patients hospitalized in the ICU was indeed more severe compared to patients in the ward, and the need for mechanical ventilation, incidence of complications, and death rates were higher in overweight/obese patients. The systematic review demonstrated that overweight and obesity contribute to longer hospital stays and other severe outcomes of COVID-19.