Role of body mass index in outcomes of patients hospitalized with COVID‐19 illness

Abstract

Background: Since the start of coronavirus disease 2019 (COVID-19) pandemic, several studies have linked obesity with severity of illness as well as mortality in patients with COVID-19. Outcomes of patients with overweight or obesity, who develop critical illness, have been studied extensively over the past decade where the studies have shown conflicting results. In this study, we aimed to assess the association between the body mass index (BMI) classes and outcomes among hospitalized patients with COVID-19.Methods: This was a retrospective chart review of all adults admitted to our hospital with COVID-19 illness between 1 March 2020 and 30 June 2020. Patients were divided into four groups based on their BMI range as follows: patients with underweight (BMI < 18.5 kg/m 2 ), patients with normal weight (BMI 18.5-24.9 kg/m 2 ), patients with overweight (BMI 25-29.9 kg/m 2 ), and patients with obesity (BMI ≥ 30 kg/m 2 ).Results: 1274 patients were admitted during the study period. There were 24(1.9%) patients with underweight, 268 (21%) patients with normal weight, 445 (34.9%) patients with overweight, and 537 (42.2%) patients with obesity. Patients with obesity were younger (p < 0.001) and there were more females among patients with underweight and patients with obesity (54% and 48% respectively, p < 0.001).There were no differences in subgroup with regards to presence of hypertension, diabetes mellitus, coronary artery disease, congestive heart failure, and dyslipidemia. In a multivariate logistic regression model, patients with overweight and patients with obesity had higher odds of requiring mechanical ventilation. BMI class was not associated with difference in survival time in a multivariate analysis. Conclusions:In our large single-center study of hospitalized patients with COVID-19, patients with overweight and obesity had higher need for mechanical ventilation but had similar mortality when compared to patients with normal weight and underweight.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Higher body mass index is strongly linked to poor outcomes in adult COVID‐19 hospitalizations: A National Inpatient Sample Study

“…Lastly, a retrospective study of the first 277 consecutive COVID-19 patients admitted to Massachusetts General Hospital ICU found no difference in outcomes between BMI groups, including 30-and 60-day mortality and duration of mechanical ventilation. 8 However, this study did not control for comorbidities, and, similar to the studies by Bhasin et al 5 and Zahid et al, 7 patients with obesity tended to be younger (median age 56 [IQR 46-66] vs. 66 [IQR 54-76] p < 0.05) than patients without obesity.…”

“…Patients who were underweight were included in the <30 kg/m 2 group, however, limiting its interpretability. A large single center retrospective study in Bronx, NY, including 1274 hospitalized patients with COVID‐19 pneumonia between 1 March and 30 June 2020, found no association between survival and BMI groups using a Kaplan–Meier survival estimate ( p = 0.7746) 7 . BMI class was not associated with difference in survival time in a multivariate analysis.…”

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.…”