Some features of the course of viral pneumonia in obesity

Intriduction. In the last decade, conflicting data has appeared that the presence of obesity in patients with several diseases not only does not worsen, but even improves their prognosis, which is called the “obesity paradox”. The role of elevated body mass index in patients with coronavirus pneumonia (COVID-19) remains unclear.

Aim. To study the features of the course of pneumonia in young and middle-aged men depending on the body mass index.

Materials and methods. A retrospective analysis has investigated and it included 451 young and middle-aged men who underwent inpatient treatment for COVID-19 pneumonia. Patients were randomized according to body mass index into groups: normal nutrition (N), overnutrition (On), obesity (Ob). Clinical and laboratory parameters were assessed using statistical analysis.

Results and discussion. In patients with obesity, the causative agent of pneumonia was detected in 91.9% of cases, in contrast to group N (65.75%). At the onset of pneumonia, group Ob differed significantly from group N in terms of erythrocyte sedimentation rate (17 versus 9 mm/h), C-reactive protein (18.3 versus 7.2 mg/l), D-dimer (304 versus 230 ng/ml), glycemia (6.2 versus 5.2 mmol/l), lymphocytes 9 (1.3 versus 1.5 × 10⁹/l). In the dynamics in the group Ob, in comparison with the group N, there is a higher level of platelets (307 versus 1 × 10⁹/l), neutrophils (6.3 versus 3.7 × 10⁹/l), monocytes (0.8 versus 0.6 × 10⁹/l) and a smaller number of lymphocytes (1.4 versus 2.0 × 10⁹/l). It was revealed that the lymphocytic index and the index of the ratio of lymphocytes to monocytes in dynamics significantly increase in group N (from 0.5 to 0.7 and from 3.5 to 4.5, respectively), in group On only the lymphocyte index significantly increases (from 0.4 to 0.5), in the obesity group they do not change (from 0.4 to 0.5 and 3 from.0 to 2.7, respectively). The greatest need for respiratory support had group Ob (21.1%) in comparison with GNP (6.0%).

Conclusions. The level of adipose tissue in the body has a direct impact on the course of pneumonia.

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