Association of Body Mass Index with Early Inflammatory and Coagulation Biomarker Patterns and Intensive Care Unit Mortality in Critically Ill Patients with COVID-19: A Retrospective Cohort Study
- 1Department of Anesthesiology and Intensive Care, Medical University of Bialystok, 15-089 Bialystok, Poland
- 2Medical University of Bialystok, 15-089 Bialystok, Poland
- 3Department of Emergency Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
Abstract
Background/Objectives: The association of body mass index (BMI) with outcomes after intensive care unit (ICU) admission remains uncertain. We examined ICU mortality and early biomarker patterns in adults with COVID-19. Methods: This single-center retrospective secondary analysis included 201 patients. BMI was analyzed per 5 kg/m2 using logistic regression for mortality and generalized estimating equations for biomarkers, adjusted for age, sex, and calendar time. Six inflammatory and coagulation biomarkers were averaged within four consecutive 24 h intervals covering the first 96 h after ICU admission. False-discovery-rate correction and missingness sensitivity analyses were performed. Results: Eighty patients died (39.8%). The adjusted mortality odds ratio was 1.02 (95% CI 0.82–1.26). Joint tests of interval-specific BMI associations were significant for interleukin-6 (IL-6) and white blood cell count, but not the other four biomarkers under the primary specification. Only IL-6 at 24–48 h remained significant after correction across 24 contrasts (−35.9% per 5 kg/m2 higher BMI; 95% CI −49.4 to −18.8; q = 0.006), based on 40/201 patients. Conclusions: Within this selected ICU cohort, BMI showed no clear adjusted mortality association and biomarker findings were heterogeneous. The isolated inverse IL-6 association remains exploratory because of sparse measurements and potentially informative missingness and requires independent confirmation with standardized sampling.
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BibTeX
@article{korabiewski2026association,
title = {{Association of Body Mass Index with Early Inflammatory and Coagulation Biomarker Patterns and Intensive Care Unit Mortality in Critically Ill Patients with COVID-19: A Retrospective Cohort Study}},
author = {Mikołaj Korabiewski and Izabela Płońska-Korabiewska and Sławomir Lech Czaban and Jerzy Robert Ładny and Mateusz Bartoszewicz},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207799},
url = {https://www.mdpi.com/2077-0383/15/20/7799},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of Body Mass Index with Early Inflammatory and Coagulation Biomarker Patterns and Intensive Care Unit Mortality in Critically Ill Patients with COVID-19: A Retrospective Cohort Study
AU - Mikołaj Korabiewski
AU - Izabela Płońska-Korabiewska
AU - Sławomir Lech Czaban
AU - Jerzy Robert Ładny
AU - Mateusz Bartoszewicz
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207799
UR - https://www.mdpi.com/2077-0383/15/20/7799
AB - Background/Objectives: The association of body mass index (BMI) with outcomes after intensive care unit (ICU) admission remains uncertain. We examined ICU mortality and early biomarker patterns in adults with COVID-19. Methods: This single-center retrospective secondary analysis included 201 patients. BMI was analyzed per 5 kg/m2 using logistic regression for mortality and generalized estimating equations for biomarkers, adjusted for age, sex, and calendar time. Six inflammatory and coagulation biomarkers were averaged within four consecutive 24 h intervals covering the first 96 h after ICU admission. False-discovery-rate correction and missingness sensitivity analyses were performed. Results: Eighty patients died (39.8%). The adjusted mortality odds ratio was 1.02 (95% CI 0.82–1.26). Joint tests of interval-specific BMI associations were significant for interleukin-6 (IL-6) and white blood cell count, but not the other four biomarkers under the primary specification. Only IL-6 at 24–48 h remained significant after correction across 24 contrasts (−35.9% per 5 kg/m2 higher BMI; 95% CI −49.4 to −18.8; q = 0.006), based on 40/201 patients. Conclusions: Within this selected ICU cohort, BMI showed no clear adjusted mortality association and biomarker findings were heterogeneous. The isolated inverse IL-6 association remains exploratory because of sparse measurements and potentially informative missingness and requires independent confirmation with standardized sampling.
SN - 2077-0383
ER -