{"doi":"10.1210/clinem/dgae273","title":"Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study","abstract":"CONTEXT: Obesity is a risk factor for coronavirus disease 2019 (COVID-19)-related outcomes; however, the mechanism remains unclear. OBJECTIVE: The objective of this analysis was to determine whether inflammation mediates the association between obesity and COVID-19 outcomes. METHODS: The International Study of Inflammation in COVID-19 (ISIC): A Prospective Multi-Center Observational Study Examining the Role of Biomarkers of Inflammation in Predicting Covid-19 Related Outcomes in Hospitalized Patients, was conducted at 10 hospitals in the United States and Europe. Participants were adults hospitalized specifically for COVID-19 between February 1, 2020, through October 19, 2022. Inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), were measured at admission. Associations were examined between body mass index (BMI, kg/m2) and a composite of death, need for mechanical ventilation, and renal replacement therapy, stratified by pre- and post-Omicron variants. The contribution of inflammation to the relationship between obesity and outcomes was assessed. RESULTS: Among 4644 participants (mean age 59.3, 45.6% male, 21.8% BMI ≥ 35), those with BMI > 40 (n = 485) had 55% higher odds of the composite outcome (95% CI, 1.21-1.98) compared with nonobese individuals (BMI < 30, n = 2358) in multivariable analysis. In multiple mediation analysis, only suPAR remained a significant mediator between BMI and composite outcome. Associations were amplified for participants younger than 65 years and with pre-Omicron variants. CONCLUSION: Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2024,"id":433920,"datarank":0.3958585994422889,"base_score":2.639057329615259,"endowment":2.639057329615259,"self_citation_contribution":0.3958585994422889,"citation_network_contribution":0.0,"self_endowment_contribution":0.3958585994422889,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9208,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":781918,"name":"Kishan Padalia","orcid":null,"position":1,"is_corresponding":false},{"id":443667,"name":"Alexi Vasbinder","orcid":"0000-0002-1380-5364","position":2,"is_corresponding":false},{"id":884760,"name":"Yiyuan Huang","orcid":"0000-0001-5568-8517","position":3,"is_corresponding":false},{"id":855053,"name":"Anis Ismail","orcid":"0000-0003-4144-0160","position":4,"is_corresponding":false},{"id":1072192,"name":"Ian Pizzo","orcid":null,"position":5,"is_corresponding":false},{"id":993301,"name":"Kristen Machado Diaz","orcid":"0009-0007-2078-2117","position":6,"is_corresponding":false},{"id":885307,"name":"Tonimarie Catalan","orcid":null,"position":7,"is_corresponding":false},{"id":855049,"name":"Feriel Presswalla","orcid":"0000-0001-7190-5622","position":8,"is_corresponding":false},{"id":258828,"name":"Elizabeth Anderson","orcid":"0000-0003-0692-3642","position":9,"is_corresponding":false},{"id":855052,"name":"Grace Erne","orcid":"0000-0003-1236-3901","position":10,"is_corresponding":false},{"id":982531,"name":"Brayden Bitterman","orcid":null,"position":11,"is_corresponding":false},{"id":855050,"name":"Pennelope Blakely","orcid":"0000-0002-9677-3010","position":12,"is_corresponding":false},{"id":65658,"name":"Evangelos J. Giamarellos‐Bourboulis","orcid":"0000-0003-4713-3911","position":13,"is_corresponding":false},{"id":259656,"name":"Sven H. Loosen","orcid":"0000-0003-3447-1161","position":14,"is_corresponding":false},{"id":569,"name":"Frank Tacke","orcid":"0000-0001-6206-0226","position":15,"is_corresponding":false},{"id":52862,"name":"Athanasios Chalkias","orcid":"0000-0002-7634-4665","position":16,"is_corresponding":false},{"id":607082,"name":"Jochen Reiser","orcid":"0000-0002-0460-662X","position":17,"is_corresponding":false},{"id":41007,"name":"Jesper Eugen‐Olsen","orcid":"0000-0002-4630-4275","position":18,"is_corresponding":false},{"id":277440,"name":"Mousumi Banerjee","orcid":"0000-0001-5901-822X","position":19,"is_corresponding":false},{"id":231193,"name":"Rodica Pop‐Busui","orcid":"0000-0002-2042-1350","position":20,"is_corresponding":false},{"id":263299,"name":"Salim S. Hayek","orcid":"0000-0003-0180-349X","position":21,"is_corresponding":false},{"id":1239647,"name":"Christina G. 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