Obesity represents a major comorbidity that exacerbates the clinical course and outcomes of infectious diseases. Respiratory changes in obese individuals may exacerbate the impact of COVID-19, leading to severe ARDS. Understanding the factors influencing hospitalization outcomes in obese patients with severe ARDS is crucial for optimizing patient care. Objectives: To identify variables at ICU admission that could predict the hospitalization outcome of obese patients with severe ARDS due to COVID-19.

A retrospective study was conducted on obese patients diagnosed with severe ARDS due to COVID-19. Data on clinical, laboratory, and mechanical ventilation parameters within the first 6 h post-endotracheal intubation were collected and analyzed. Logistic regression analysis was employed to determine the impact of various variables on hospitalization outcomes.

Eighty-four patients were allocated into Survivors Group (SG; n = 45) and Non-survivors Group (NSG; n = 39). Differences in potassium levels (SG: 4.16 ± 0.58; NSG: 4.52 ± 1.03; p = 0.05), pH (SG: 7.33 ± 0.09; NSG: 7.27 ± 0.09; p = 0.004), O₂Sat (SG: 94.38 ± 3.57; NSG: 92.65 ± 4.41; p = 0.033), and ventilatory ratio (VR) (SG: 1.96 ± 0.77; NSG: 2.24 ± 0.63; p = 0.02) were observed between groups, indicating that changed levels of these variables were associated with increased risk of death.

Variables such as potassium, pH, O₂Sat and VR levels can predict the outcome of death in the ICU admission. These findings highlight the importance of early assessment and monitoring of these parameters to optimize patient management and improve outcomes in this high-risk population.