Higher levels of c-reactive protein in patients with overweight and sars-cov-2 related pneumonia

Introduction: Overweight and obesity are associated with a more severe COronaVirus Disease 19 (COVID-19). Adipose tissue related chronic inflammation could be a promoter for the occurrence of the cytokine storm that predicts aggravation of COVID-19. Primary aim was to investigate if this increased risk for more severe COVID-19 was associated with a higher inflammatory response. Methods: We enrolled patients <75 years old hospitalized in a medical COVID-19 ward with SARS-CoV-2 related pneumonia. Patients were classified according to Body Mass Index as normal weight, overweight and obesity. Laboratory parameters were measured at admission and every second day during the hospital stay. The time (in days) between the onset of COVID-19 symptoms and admission in the hospital and between the onset of COVID-19 symptoms and the day in which the maximal value was observed for each biochemical variable were also recorded. Results: 90 patients (64.4% males;median age 61 years) were enrolled. Invasive Mechanical Ventilation (IMV) was needed in 9% of the patients with a normal weight, in 32.4% of the patients with overweight and in 12.9% of the patients with obesity (p=0.045). Maximal C-Reactive Protein (CRP) level during hospital stay was 92 (48-122) mg/L in patients with a normal weight, 140 (82-265) mg/L in patients with overweight, and 117 (67-160) mg/L in patients with obesity (p=0.037). Conclusion: Patients with overweight had increased need in IMV than patients with obesity and normal weight;patients with overweight and obesity had higher peak of CRP than patients with normal weight during COVID-19.