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Obesity is associated with higher risk of intensive care unit admission and death in influenza A (H1N1) patients: a systematic review and meta-analysis

Authors

  • L. Fezeu,

    1. Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
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  • C. Julia,

    1. Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
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  • A. Henegar,

    1. Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
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  • J. Bitu,

    1. Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
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  • F. B. Hu,

    1. Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA
    2. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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  • D. E. Grobbee,

    1. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
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  • A.-P. Kengne,

    1. George Institute for International Health, University of Sydney, Sydney, Australia
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  • S. Hercberg,

    1. Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
    2. Département de Santé Publique, Hôpital Avicenne (AP-HP), Université Paris 13, Bobigny, France
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  • S. Czernichow

    Corresponding author
    1. Nutritional Epidemiology Research Unit-UMR U557 INSERM, U1125 INRA, CNAM, Paris 13 University, Bobigny, France
    2. Département de Santé Publique, Hôpital Avicenne (AP-HP), Université Paris 13, Bobigny, France
      Dr S Czernichow, Faculté de médecine SMBH, 74 rue Marcel Cachin, 93017 Bobigny, France. E-mail: s.czernichow@uren.smbh.univ-paris13.fr
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Dr S Czernichow, Faculté de médecine SMBH, 74 rue Marcel Cachin, 93017 Bobigny, France. E-mail: s.czernichow@uren.smbh.univ-paris13.fr

Summary

The aim of this study was to assess the association between obesity and the risk of intensive care unit (ICU) admission and death among patients hospitalized for influenza A (H1N1) viral infection. A systematic review of the Medline and Cochrane databases using ‘obesity’, ‘hospitalization’, ‘influenza A viral infection’, various synonyms, and reference lists of retrieved articles from January 2009 to January 2010. Studies comparing the prevalence of obesity among patients with confirmed infection for influenza A virus and who were either hospitalized or admitted to ICU/died were included. A total of 3059 subjects from six cross-sectional studies, who were hospitalized for influenza A (H1N1) viral infection, were included in this meta-analysis. Severely obese H1N1 patients (body mass index ≥ 40 kg m−2, n = 804) were as twice as likely to be admitted to ICU or die (odds ration: 2.01, 95% confidence interval: 1.29–3.14, P < 0.002) compared with H1N1 patients who were not severely obese. Having a body mass index ≥ 30 kg m−2 was similarly associated with a more than twofold increased risk of ICU admission or death although this did not reach statistical significance (2.14, 0.92–4.99, P < 0.07). This meta-analysis supports the view that obesity is associated with higher risks of ICU admission or death in patients with influenza A (H1N1) infection. Therefore, morbid obese patients should be monitored more intensively when hospitalized.

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