Body mass index and severity/fatality from coronavirus disease 2019: A nationwide epidemiological study in Korea

Abstract

Objective Obesity has been reported as a risk factor for severe coronavirus disease 2019 (COVID-19) in recent studies. However, the relationship between body mass index (BMI) and COVID-19 severity and fatality are unclear. Research design and methods This study included 4,141 COVID-19 patients who were released from isolation or had died as of April 30, 2020. This nationwide data was provided by the Korean Centers for Disease Control and Prevention Agency. BMI was categorized as follows; < 18.5 kg/m2, 18.5–22.9 kg/m2, 23.0–24.9 kg/m2, 25.0–29.9 kg/m2, and ≥ 30 kg/m2. We defined a fatal illness if the patient had died. Results Among participants, those with a BMI of 18.5–22.9 kg/m2 were the most common (42.0%), followed by 25.0–29.9 kg/m2 (24.4%), 23.0–24.9 kg/m2 (24.3%), ≥ 30 kg/m2 (4.7%), and < 18.5 kg/m2 (4.6%). In addition, 1,654 (41.2%) were men and 3.04% were fatalities. Multivariable analysis showed that age, male sex, BMI < 18.5 kg/m2, BMI ≥ 25 kg/m2, diabetes mellitus, chronic kidney disease, cancer, and dementia were independent risk factors for fatal illness. In particular, BMI < 18.5 kg/m2 (odds ratio [OR] 3.97, 95% CI 1.77–8.92), 25.0–29.9 kg/m2 (2.43, 1.32–4.47), and ≥ 30 kg/m2 (4.32, 1.37–13.61) were found to have higher ORs than the BMI of 23.0–24.9 kg/m2 (reference). There was no significant difference between those with a BMI of 18.5–22.9 kg/m2 (1.59, 0.88–2.89) and 23.0–24.9 kg/m2. Conclusions This study demonstrated a non-linear (U-shaped) relationship between BMI and fatal illness. Subjects with a BMI of < 18.5 kg/m2 and those with a BMI ≥ 25 kg/m2 had a high risk of fatal illness. Maintaining a healthy weight is important not only to prevent chronic cardiometabolic diseases, but also to improve the outcome of COVID-19.

Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish Nationwide Cohort Study (TurCObesity)

“…Unauthorized distribution is strictly prohibited. [26]. In our study, the overall mortality rate was 3.2 %, although we observed a significantly increased mortality in both overweight (3.6 %) and obese (4.7 %) groups compared to that in the normal weight group (1.4 %).…”

Inflammatory laboratory findings associated with severe illness among hospitalized individuals with COVID-19 in Medan, Indonesia: a cross-sectional study

“… 37 Subjects with a BMI of less than 18.5 kg/m 2 and greater than 25 kg/m 2 have a higher risk for a fatal illness. 38 In this study, a total of 36.35% were obese and 6.25% were underweight based on Asian BMI criteria. Obesity is one of the risk factors for cardiometabolic disease and is reported to cause immune system dysregulation.…”

Inflammatory laboratory findings associated with severe illness among hospitalized individuals with COVID-19 in Medan, Indonesia: a cross-sectional study

“…37 Subjects with a BMI of less than 18.5 kg/m 2 and greater than 25 kg/m 2 have a higher risk for fatal illness. 38 In this study, a total of 36.35% were obese and 6.25% were underweight based on Asian BMI criteria. Obesity is one of the risk factors for cardiometabolic disease and is reported to cause immune system dysregulation.…”