Advertisement

Letter in response to article in journal of infection: “Clinical characteristics of 345 patients with coronavirus disease 2019 in Japan: A multicenter retrospective study”

Published:September 27, 2020DOI:https://doi.org/10.1016/j.jinf.2020.09.030
      We read with great interest the study by Ishii M et al., in which hyperuricemia was deemed a novel risk factor for COVID-related death.
      • Ishii M.
      • Terai H.
      • Kabata H.
      • Masaki K.
      • Chubachi S.
      • Tateno H.
      • et al.
      Clinical characteristics of 345 patients with coronavirus disease 2019 in Japan: a multicenter retrospective study [published online ahead of print, 2020 Sep 10].
      In this study, severity was defined as the need for oxygen supplementation. Respiratory failure is indeed the most important pathology that contributes to the severity of COVID-19. Obesity is associated with restrictive breathing patterns and reduced lung volumes and is a risk factor for acute respiratory distress syndrome.
      • Simonnet A.
      • Chetboun M.
      • Poissy J.
      • Raverdy V.
      • Noulette J.
      • Duhamel A.
      • et al.
      High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation.
      Furthermore, it is also reported as an independent risk factor for the severity of COVID-19.
      • Petrilli C.M.
      • Jones S.A.
      • Yang J.
      • Rajagopalan H.
      • O’Donnell L.
      • Chernyak Y.
      • et al.
      Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study.
      ,
      • Docherty A.B.
      • Harrison E.M.
      • Green C.A.
      • Hardwick H.E.
      • Pius R.
      • Norman L.
      • et al.
      Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study.
      We have previously reported that the association of hypertension, diabetes, and ethnicities, all of which that correlate to obesity, with the severity of COVID-19 and H1N1 may be confounded by obesity to a considerable extent.
      • Miyazawa D
      Why obesity, hypertension, diabetes, and ethnicities are common risk factors for COVID-19 and H1N1 influenza infections [published online ahead of print, 2020 Jun 24].
      Hyperuricemia and obesity are known to be significantly correlated. Although multiple regression analysis showed that hyperuricemia is an independent risk factor for COVID-related death, the analysis did not include obesity or body mass index as an explanatory variable. Therefore, to truly show that hyperuricemia is a novel risk factor for COVID-related death, a multiple regression analysis including obesity as an explanatory variable is warranted.

      Declaration of Competing Interest

      None.

      References

        • Ishii M.
        • Terai H.
        • Kabata H.
        • Masaki K.
        • Chubachi S.
        • Tateno H.
        • et al.
        Clinical characteristics of 345 patients with coronavirus disease 2019 in Japan: a multicenter retrospective study [published online ahead of print, 2020 Sep 10].
        J Infect. 2020; https://doi.org/10.1016/j.jinf.2020.08.052
        • Simonnet A.
        • Chetboun M.
        • Poissy J.
        • Raverdy V.
        • Noulette J.
        • Duhamel A.
        • et al.
        High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation.
        Obes Silver Spring. 2020; 28: 1195-1199https://doi.org/10.1002/oby.22831
        • Petrilli C.M.
        • Jones S.A.
        • Yang J.
        • Rajagopalan H.
        • O’Donnell L.
        • Chernyak Y.
        • et al.
        Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study.
        BMJ. 2020; (369:m1966. Published 2020 May 22)https://doi.org/10.1136/bmj.m1966
        • Docherty A.B.
        • Harrison E.M.
        • Green C.A.
        • Hardwick H.E.
        • Pius R.
        • Norman L.
        • et al.
        Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study.
        BMJ. 2020; (369:m1985. Published 2020 May 22)https://doi.org/10.1136/bmj.m1985
        • Miyazawa D
        Why obesity, hypertension, diabetes, and ethnicities are common risk factors for COVID-19 and H1N1 influenza infections [published online ahead of print, 2020 Jun 24].
        J Med Virol. 2020; https://doi.org/10.1002/jmv.26220