体质指数与新型冠状病毒肺炎严重程度的相关性

目的探讨体质指数(BMI)、肥胖/超重与新型冠状病毒肺炎(COVID-19)病情严重程度的相关性.方法回顾性分析2020年1月至3月COVID-19确诊患者的临床资料,纳入18~60岁无糖尿病、高血压、肿瘤等慢性合并症患者59例,按照BMI分为正常BMI组(BMI≥18.5kg/m^2且<24kg/m^2,40例)和超重/肥胖组(BMI≥24kg/m^2,19例),比较两组体温、生化指标、血常规、氧合指数、肺部影像学表现、临床分型等.结果病程中超重/肥胖组最高体温、血糖、丙氨酸转氨酶、重型发病率、肺炎病变面积明显高于正常BMI组,氧合指数显著低于正常BMI组,两组比较差异有统计学意义(P<0.05);两组在性别、年龄、发病至入院的时间、白细胞、淋巴细胞、C反应蛋白、血肌酐相比较,差异无统计学意义(P>0.05).结论超重/肥胖人群合并COVID-19,肺部病变范围较广,重型较多,易出现继发性血糖升高,应重视这类患者的临床管理与治疗.

Objective To analyze the impact of body mass index(BMI),overweight and obesity on the progression of the new coronavirus disease 2019(COVID-19).Methods A retrospective study was conducted based on the clinical data from the hospitalized adult patients with COVID-19 from January 20,2020 to March 20,2020 at Hangzhou Xixi Hospital.A total of 59 patients aged from 16 to 60 years old were included,who did not have co-morbidities of chronic diseases such as diabetes,hypertension and tumors.They were divided into two groups based on BMI:normal group(BMI≥18.5kg/m^2 and<24kg/m^2,40 cases)and overweight/obesity group(BMI≥24kg/m^2,19 cases).Temperature,biochemical indices,blood test,oxygenation index,pulmonary CT findings,disease types and some other clinical characteristics were examined between different groups.Results Compared with the normal group,patients in the overweight/obesity group showed significandy increased levels of highest temperature,blood glucose,ALT,the portion of severe cases and the area of pneumonia,and a significantly decreased level of the oxygenation index(P<0.05).On the other hand,no statistical significant difference could be observed for gender,age,onset-to-door time,white cell count,total peripheral lymphocyte count,C-reactive protein and blood creatinine(P>0.05).Conclusion Comorbidities of overweight/obesity in patients with COVID—19 may lead to a wider range of lung lesion,more severe symptoms of disease and increased susceptibility to secondary hyperglycemia.It is important to pay more attention to the clinical management and treatment of those patients.