• M Balik, E Svobodova, M Porizka, M Maly, P Brestovansky, L Volny, T Brozek, T Bartosova, I Jurisinova, Z Mevaldova, O Misovic, A Novotny, J Horejsek, M Otahal, M Flaksa, Z Stach, J Rulisek, P Trachta, J Kolman, R Sachl, J Kunstyr, P Kopecky, S Romaniv, M Huptych, M Svarc, G Hodkova, J Fichtl, F Mlejnsky, T Grus, J Belohlavek, M Lips, and J Blaha.
• Department of Anesthesiology and Intensive Care, 1(st) Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic. Electronic address: martin.balik@vfn.cz.
• J Crit Care. 2022 Dec 1; 72: 154162154162.

PurposeThe aim was to verify the impact of obesity on the long-term outcome of patients with severe SARS-CoV-2 ARDS.Materials And MethodsThe retrospective study included patients admitted to the high-volume ECMO centre between March 2020 and March 2022. The impact of body mass index (BMI), co-morbidities and therapeutic measures on the short and 90-day outcomes was analysed.Results292 patients were included, of whom 119(40.8%) were treated with veno-venous ECMO cannulated mostly (73%) in a local hospital. 58.5% were obese (64.7% on ECMO), the ECMO was most frequent in BMI > 40(49%). The ICU mortality (36.8% for obese vs 33.9% for the non-obese, p = 0.58) was related to ECMO only for the non-obese (p = 0.04). The 90-day mortalities (48.5% obese vs 45.5% non-obese, p = 0.603) of the ECMO and non-ECMO patients were not significantly influenced by BMI (p = 0.47, p = 0.771, respectively). The obesity associated risk factors for adverse outcome were age <50 (RR 2.14) and history of chronic immunosuppressive therapy (RR 2.11, p = 0.009). The higher dosage of steroids (RR 0.57, p = 0.05) associated with a better outcome.ConclusionsThe high incidence of obesity was not associated with worse short and long-term outcomes. ECMO in obese patients together with the use of steroids in the later stage of ARDS may improve survival.Copyright © 2022 Elsevier Inc. All rights reserved.

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