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Oxygen Requirement in Overweight/Obese Kidney Transplant Recipients with COVID-19: An Observational Cohort Study
oleh: Alexandre Veronese-Araújo, Débora D. de Lucena, Isabella Aguiar-Brito, Luís Gustavo Modelli de Andrade, Marina P. Cristelli, Hélio Tedesco-Silva, José O. Medina-Pestana, Érika B. Rangel
| Format: | Article |
|---|---|
| Diterbitkan: | MDPI AG 2023-06-01 |
Deskripsi
Introduction: Obesity is one of the components of the cardiometabolic syndrome that contributes to COVID-19 progression and mortality. Immunosuppressed individuals are at greater risk of the COVID-19 burden. Therefore, we sought to investigate the impact of the combination of overweight/obesity and kidney transplant on oxygen (O<sub>2</sub>) requirements in the COVID-19 setting. Methods: Retrospective analysis of 284 kidney transplant recipients (KTRs) from March/2020 to August/2020 in a single center. We investigated the risk factors associated with O<sub>2</sub> requirements in overweight/obese KTRs. Results: Overall, 65.1% had a BMI (body mass index) ≥ 25 kg/m<sup>2</sup>, 52.4% were male, the mean age was 53.3 ± 11 years old, 78.4% had hypertension, and 41.1% had diabetes mellitus. BMI was an independent risk factor for O<sub>2</sub> requirements (OR = 1.07, <i>p</i> = 0.02) alongside age, lymphopenia, and hyponatremia. When overweight/obese KTRs were older, smokers, they presented higher levels of lactate dehydrogenase (LDH), and lower levels of estimated glomerular filtration rate (eGFR), lymphocytes, and sodium at admission, and they needed O<sub>2</sub> more often. Conclusion: Being overweight/obese is associated with greater O<sub>2</sub> requirements in KTRs, in particular in older people and smokers, with worse kidney allograft functions, more inflammation, and lower sodium levels. Therefore, the early identification of factors that predict a worse outcome in overweight/obese KTRs affected by COVID-19 contributes to risk stratification and therapeutic decisions.