How useful are body mass index and history of diabetes in COVID-19 risk stratification?

Abstract

Objective This study examines the value of risk stratification by documented diagnosis of diabetes and objectively measured height and weight (BMI) in COVID-19 severity and mortality in a large sample of patients in an urban hospital located in Southern California. Methods Data from a retrospective cohort study of COVID-19 patients treated at Cedars-Sinai Medical Center between March 8, 2020, and January 25, 2021, was analyzed. Sociodemographic characteristics and pre-existing conditions were extracted from electronic medical records. Univariable and multivariable logistic regression models identified associated risk factors, and a regression causal mediation analysis examined the role of diabetes in the association between obesity and illness severity. All analyses were stratified by age (<65 and ≥65). Results Among individuals <65yo, diabetes accounted for 19–30% of the associations between obesity and COVID-19 illness severity. Among patients ≥65yo, having a BMI <18.5 was a risk factor for mortality regardless of diabetes history. Conclusion Our findings have clinical implications in documenting which patients may be at elevated risk for adverse outcomes. More in-depth prospective studies are needed to capture how glycemic regulation may influence prognosis.

Predicting Intensive Care Unit Admission for COVID-19 Patients from Laboratory Results

“…In line with our findings, a national study conducted in Saudi Arabia reported that the two most common comorbidities in COVID-19 patients were diabetes and hypertension [ 31 ]. However, these are in contrast to another study which found a lack of association between diabetes and COVID-19 severity [ 32 ]. This highlights variation between different populations and the importance of national surveillance studies.…”

Obesity as a Risk Factor for Complications and Mortality in Individuals with SARS-CoV-2: A Systematic Review

“…The remaining 35 studies were assessed for methodological quality using the Downs and Black scale. Of them, 27 studies were excluded due to low methodological quality, leaving 8 studies that met all the selection criteria [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ].…”

“…Of the 35 studies selected for the methodological assessment using the Downs and Black scale [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 ], 1 study scored 6/17 [ 35 ], 3 scored 7/10 [ 36 , 37 , 38 ], 11 scored 8/17 [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ], 12 scored 9/17 [ 50 , 51 ,…”

“…One study was carried out in Serbia [ 29 ], one in Turkey [ 30 ], one in Brazil [ 31 ], one in China [ 33 ], and four in the United States of America [ 27 , 28 , 32 , 34 ]. These studies analyzed nutritional status, use of oxygen support, mortality rate, and biochemical profiles in adults hospitalized with SARS-CoV-2.…”

“…Regarding the main comorbidities of COVID-19 positive adults, diabetes mellitus (DM) was also present in eight studies, with a prevalence ranging from 2% to 53% [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], chronic obstructive pulmonary disease was present in eight studies, ranging from 3.2% to 25.6% [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ], systemic arterial hypertension (SAH) was present in seven studies, ranging from 31% to 83% [ 27 , 29 , 30 , 31 , 32 , 33 , 34 ], and cardiovascular diseases (acute myocardial infarction, congestive heart failure, chronic heart disease, coronary artery disease, and atrial fibrillation) were present in seven studies, ranging from 5.3% to 32.5% of the sample [ 27 , 28 , 30 , 31 , 32 , 33 , 34 ].…”