Friedman, Allon N.Guirguis, JohnKapoor, RajatGupta, ShrutiLeaf, David E.Timsina, Lava R.2022-11-082022-11-082021-10Friedman, A. N., Guirguis, J., Kapoor, R., Gupta, S., Leaf, D. E., Timsina, L. R., & STOP-COVID Investigators. (2021). Obesity, inflammatory and thrombotic markers, and major clinical outcomes in critically ill patients with COVID-19 in the US. Obesity (Silver Spring, Md.), 29(10), 1719–1730. https://doi.org/10.1002/oby.232451930-7381, 1930-739Xhttps://hdl.handle.net/1805/30493OBJECTIVE: This study aimed to determine whether obesity is independently associated with major adverse clinical outcomes and inflammatory and thrombotic markers in critically ill patients with COVID-19. METHODS: The primary outcome was in-hospital mortality in adults with COVID-19 admitted to intensive care units across the US. Secondary outcomes were acute respiratory distress syndrome (ARDS), acute kidney injury requiring renal replacement therapy (AKI-RRT), thrombotic events, and seven blood markers of inflammation and thrombosis. Unadjusted and multivariable-adjusted models were used. RESULTS: Among the 4,908 study patients, mean (SD) age was 60.9 (14.7) years, 3,095 (62.8%) were male, and 2,552 (52.0%) had obesity. In multivariable models, BMI was not associated with mortality. Higher BMI beginning at 25 kg/m2 was associated with a greater risk of ARDS and AKI-RRT but not thrombosis. There was no clinically significant association between BMI and inflammatory or thrombotic markers. CONCLUSIONS: In critically ill patients with COVID-19, higher BMI was not associated with death or thrombotic events but was associated with a greater risk of ARDS and AKI-RRT. The lack of an association between BMI and circulating biomarkers calls into question the paradigm that obesity contributes to poor outcomes in critically ill patients with COVID-19 by upregulating systemic inflammatory and prothrombotic pathways.en-USPublisher PolicyBiomarkersInflammationRespiratory Distress SyndromeAcute Kidney InjuryArticle