key: cord-0850843-scactniz
authors: Luo, Xiao; Jiaerken, Yeerfan; Shen, Zhujing; Wang, Qiyuan; Liu, Bo; Zhou, Haisheng; Zheng, Hanpeng; Li, Yongchou; Gao, Yuantong; He, Susu; Ji, Wenbin; Liu, Yongqiang; Ma, Jianbing; Mao, Longyun; Wang, Xiangming; Wang, Meihao; Su, Miaoguang; Huang, Peiyu; Shi, Lei; Zhang, Minming
title: Obese COVID‐19 patients show more severe pneumonia lesions on CT
date: 2020-09-18
journal: Diabetes Obes Metab
DOI: 10.1111/dom.14194
sha: ed09bab7bec4de6e692174d5f95a8052132082b4
doc_id: 850843
cord_uid: scactniz

nan

Obese patients had a greater total lesion and GGO volume in the whole/bilateral superior/right inferior lung lobe and greater consolidation in the right superior lung than normal BMI patients (p<0.05, Table 1 ). Results remained mostly unchanged corrected by the lung volume (Appendix S4), personal disease history, and demographics (Appendix S5). However, only trends of increased pneumonia lesion in overweight and underweight patients than normal BMI group were found (p>0.05). Additionally, BMI was correlated with total lesions (r=0.19, p=0.004) and consolidation (r=0.21, p=0.001). Regarding laboratory results, obese patients had higher CRP than normal BMI patients (p<0.05). Across groups, CRP was related to total lesions, GGO, and consolidation (r=0.52, 0.51, and 0.44, respectively, p<0.001). Longitudinally, across groups, total lesions increased during the first ten days after symptoms onset (peak: 276.74 mm 3 ) then gradually decreased; lesions accumulated during the first ten days while the progression rate was steadily decreasing (Figure 1 A/B) . In obesity patients, lesions peaked at the ten days (550.16 mm 3 ), and lesions rapid growth before the 7th days (peak: 38.11 mm 3 /day). By contrast, over-weighted and normal BMI patients underwent decelerating and slower lesion growth, with the peak lesions and accumulation rate lower than obesity patients (Figure 1 

Conclusively, obese COVID-19 patients had more diffuse pneumonia lesions than normal BMI patients, with lesions extending from inferior to superior lobes. 17-19 Right inferior lobe was most involved, which may be attributed to the anatomic features of the right inferior lobar bronchus (straighter and steeper than others).

Regarding pneumonia features, GGO predominates the lesions, suggesting that pulmonary interstitium are susceptible to COVID-19 virus invasion 8,17,18,20 . Longitudinally, obesity patients had a more severe disease course than normal BMI patients, which go well with evidence that these patients had worse disease prognosis. 21 Interestingly, studies also reported that obesity is associated with worse prognosis in other respiratory viruses (e.g., H1N1 influenza).

22- 25 We thus inferred that obesity effects on viral pneumonia were nonspecific. Notably,

This article is protected by copyright. All rights reserved. 

This article is protected by copyright. All rights reserved. pneumonia lesions change per day were positive value before 10-11 days, then gradually decreased. In subgroup level, C-D: obesity patients (g2, dark blue) had the greatest pneumonia lesions volume at the 10-11 days (peak:

550.16 mm 3 ), and lesions progressed fast before seven days (maximum value at the 6~7 days, 38.11 mm 3 /day).

Over-weighted (g1, blue) and normal BMI (g0, light blue) COVID-19 patients had the greatest lesions volume at 6-7 days (peak: 287.6 mm 3 ) and 8-9 days (peak: 227.86 mm 3 ), respectively; additionally, over-weighted and normal BMI COVID-19 patients had the maximum lesions at the 2-3 days. * represents a significant difference among the three groups; then post hoc t-tests showed that obesity group had greater pneumonia lesions, faster lesion growth or absorption than normal BMI group (p<0.05, Bonferroni corrected).

Accepted Article

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