Major Adverse Cardiovascular and Thromboembolic Events in Obese and Non-obese COVID- 19 ICU Patients

Dini Khairani, MD, MMSc
Department of Medicine
Division of Cardiovascular Medicine
Poster Overview

Obesity has been suggested as a risk factor for adverse outcomes in patients with COVID-19. We evaluated the characteristics and outcomes of the 81 obese and 89 non-obese patients who were admitted to the intensive care unit (ICU) with COVID-19. Approximately 9 out of 10 obese and non-obese patients received blood thinners to prevent blood clots. Even with preventive measures, there was a high rate of blood clots and cardiac problems in both patient groups. In order to prevent these serious complications in young obese patients, further study of preventive measures is necessary.

Scientific Abstract

Background: In patients with COVID-19, obesity is a suggested risk factor for cardiovascular and thromboembolic complications.

Objective: We assessed major adverse cardiovascular events (MACE) and thromboembolic outcomes in obese and non-obese patients with COVID-19 in the intensive care unit (ICU).

Methods: Using a retrospective cohort of 1114 patients with COVID-19 diagnosed and treated through the Mass General Brigham network, we analyzed the clinical characteristics, treatment, and outcomes of 170 ICU patients. We assessed 81 obese (BMI�30 kg/m2) and 89 non-obese ICU patients to compare the frequencies of adjudicated MACE and arterial and venous thromboembolism.

Results: Obese ICU patients with COVID-19 were 32.6% female and 45.7% non-white. Obese patients had a median age of 62 years compared with 64 years in non-obese patients (p<0.05). Anticoagulant thromboprophylaxis was prescribed in 90.1% of obese and 88.8% of non-obese patients (p=0.77). The frequencies of MACE and thromboembolic events was similarly high between obese and non-obese patients (37.0% vs 33.7% and 43.2% vs 48.3%, respectively).

Conclusion: Despite a thromboprophylaxis rate of 90.1% in obese patients, MACE and thromboembolic events were frequent. Further study in obese patients is warranted to understand how their risk of these events might be mitigated.

Clinical Implications
Obese patients with COVID-19 in the ICU still had blood clots and cardiac problems despite preventive blood thinners. Further study to determine safe and effective preventive measures is necessary in obese and non-obese patients.
Research Areas
Authors
Briana M. Barns, B.S., B.A., Candrika Dini Khairani, M.D., M.MSc., Mariana B. Pfeferman, B.S., Candrika Dini Khairani, M.D., M.MSc., Julia E. Snyder, B.S., Ruth H. Morrison, R.N., Samuel Z. Goldhaber, M.D., Gregory Piazza, M.D., M.S.
Principal Investigator
Gregory Piazza, M.D., M.S.

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