Obesity is prevalent in hospitalized patients with critical illness secondary to COVID-19 disease and a higher body-mass index is associated with higher hospital mortality.
︎While obesity is usually associated with unfavorable clinical outcomes in many clinical settings, previous studies suggest that obese patients with acute respiratory distress syndrome may have better outcomes. This phenomenon has been named the “obesity paradox” by some authors.
︎Possible explanations for this survival benefit include the bias towards early ICU admission of obese acute respiratory distress syndrome patients. This is due to clinicians’ fear of an unfavorable outcome leading to more aggressive and earlier interventions and monitoring in these patients compared with nonobese patients.
These potential advantages for obese patients may have been lost during the first wave of the COVID-19 pandemic since an early ICU admission policy was applied to all patients requiring relatively low levels of oxygen supplementation irrespective of their weight. Hence impacting the higher mortality in critically ill COVID-19 patients.
Source:
https://www.nature.com/articles/s41366-021-00938-8#Abs1
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