Outcomes of overweight and obese critically ill patients with severe acute respiratory infection

ObjectivesTo assess the association of obesity with outcomes among patients with severe acute respiratory infection.MethodsThis is a retrospective cohort study of patients with severe acute respiratory infection admitted to the intensive care units in four referral hospitals in Saudi Arabia between September 2012 and June 2018. Patients were classified into two groups: overweight-obese patients (body mass index ≥25 kg/m²) and normal-weight patients (body mass index between 18.5 and 24.9 kg/m²). All underweight patients with a body mass index <18.5 kg/m² were excluded from the study.ResultsOf the 421 patients, 294 were in the overweight-obese group and 127 were in the normal-weight group. There was no difference in crude 90-day mortality between the two groups. However, multivariate regression analysis showed that overweight-obese patients had lower 90-day mortality than normal-weight patients (odds ratio, 0.71; 95% confidence interval, 0.60-0.85; <i>P</i> = 0.0002). Interestingly, increasing age was associated with a significant increase in mortality (odds ratio, 1.03; 95% confidence interval, 1.02-1.03; <i>P</i> < 0.0001). Moreover, the Sequential Organ Failure Assessment score was associated with a significant increase in mortality (odds ratio, 1.21; 95% confidence interval, 1.15-1.26; <i>P</i> < 0.0001).DiscussionOur study showed lower mortality among overweight-obese patients, supporting the phenomenon of obesity paradox.ConclusionOverweight and obesity were common among patients with severe acute respiratory infection. Our study demonstrates that the obesity paradox exists among patients with severe acute respiratory infection.