The following article is a part of conference coverage from the American Association of Clinical Endocrinology Annual Meeting 2021: ENVISION, being held virtually from May 26 to May 29, 2021. The team at Endocrinology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from the AACE Annual Meeting 2021: ENVISION.

 

Poor glycemic control among inpatients with obesity was found to be associated with increased mortality from infection with COVID-19, according to study results presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).


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Researchers from Brown University and Harvard Medical School analyzed data from 1417 patients with obesity who were hospitalized with COVID-19 at the Rhode Island Hospital between March of 2020 and February of 2021.

Among all patients hospitalized for COVID-19 (N=3494), 42.3% were obese, 32.1% were overweight, and 25.6% were normal weight or underweight.

Among the obese cohort, 50.1% were class 1 (BMI 30.0-34.9 kg/m2), 26.9% were class 2 (BMI 35.0-39.9 kg/m2), and 23.0% were class 3 (BMI ≥40.0 kg/m2); 42.4% had type 2 diabetes, and 22.7% had stress hyperglycemia. The average glycated hemoglobin in this cohort was 8.3%±2.4% and blood glucose was 155.2±72.5 mg/dL.

Patients were hospitalized for an average of 8.7±18.9 days, 6.3% required mechanical ventilation, and 15.4% did not survive.

The following factors were associated with mortality: significantly older age (P <.0001), male sex (P =.0030), Hispanic ethnicity (P =.0016), type 2 diabetes (P =.0001), stress hyperglycemia (P <.0001), diabetes ketoacidosis (P <.0001), hypertension (P =.0002), and pulmonary disease (P =.0140).

Mortality was associated with mechanical ventilation (adjusted odds ratio [aOR], 15.65; 95% CI, 15.34-34.26), Hispanic ethnicity (aOR, 2.61; 95% CI, 1.27-5.38), hyperglycemia (aOR, 2.02; 95% CI, 1.15-3.54), male sex (aOR, 1.69; 95% CI, 1.02-2.82), longer stay in hospital (aOR, 1.04; 95% CI, 1.01-1.06), and older age (aOR, 0.95; 95% CI, 0.92-0.97).

These findings may have been limited by not referring to the patient population without obesity as a comparator group. It remains unclear whether poor clinical trajectories and mortality from COVID-19 differ between the obese, overweight, and normal-weight cohorts.

These data indicate that patients who are obese and are hospitalized with COVID-19 may have poorer clinical outcomes on the basis of glycemic control status.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

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Reference

Lebastchi J, Monteiro JFG, McDonnell M, Gopalakrishnan G. Impact of diabetes and glycemic control on poor outcomes in hospitalized patients with obesity and COVID-19 infection. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.