The association between body mass index and severity of Coronavirus Disease 2019 (COVID-19): A cohort study

Abstract

Objectives The coronavirus disease 2019 (COVID-19) has become a worst pandemic. The clinical characteristics vary from asymptomatic to fatal. This study aims to examine the association between body mass index (BMI) levels and the severity of COVID-19. Methods and study design A cohort study included 147 adult patients with confirmed COVID-19 were categorized into 4 groups by BMI levels on admission: <18.5 (underweight), 18.5–22.9 (normal weight), 23.0–24.9 (overweight), and ≥25.0 kg/m2 (obese). Rates of pneumonia, severe pneumonia, acute kidney injury (AKI), and ICU stay during hospitalization across BMI group was determined. Logistic regression analysis was used to determine the association between BMI and severe pneumonia. Results Of the totals, patients having a BMI <18.5, 18.5–22.9, 23.0–24.9, and ≥25.0 kg/m2 were 12.9%, 38.1%, 17.7%, and 31.3%, respectively. The rates of pneumonia and severe pneumonia tended to be higher in patients with higher BMI, whereas the rates of AKI and ICU stay were higher in patients with BMI <18.5 kg/m2 and ≥ 25 kg/m2, when compared to patients with normal BMI. After controlling for age, sex, diabetes, hypertension and dyslipidemia in the logistic regression analysis, having a BMI ≥25.0 kg/m2 was associated with higher risk of severe pneumonia (OR 4.73; 95% CI, 1.50–14.94; p = 0.003) compared to having a BMI 18.5–22.9 kg/m2. During admission, elevated hemoglobin and alanine aminotransferase levels on day 7 and 14 of illness were associated with higher BMI levels. In contrast, rising of serum creatinine levels was observed in underweight patients on days 12 and 14 of illness. Conclusions Obesity in patients with COVID-19 was associated with severe pneumonia and adverse outcomes such as AKI, transaminitis and ICU stay. Underweight patients should be closely monitored for AKI. Further studies in body composition are warranted to explore the links between adiposity and COVID-19 pathogenesis.

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

“…Meanwhile, underweight COVID-19 patients are at risk of developing acute kidney injury, which could worsen the patient's condition. 40 In this study, laboratory parameters were not significantly different within various BMI groups. This might also be influenced by other conditions of the patients.…”

Association between COVID-19 morbidity, mortality, and gross domestic product, overweight/ obesity, non-communicable diseases, vaccination rate: A cross-sectional study

“…There are still no visible and definitive ways to defeat the disease. Many studies showed that a high BMI is a cause of a lot of complications during COVID-19 [9] , [11] , [16] , [17] .…”

“…Certainly, these countries have a good system for data gathering and data sharing. Nevertheless, the economically prosperous countries differ in other specific features, for instance, these countries have a lot of people with NCD, and BMI more than 25 kg per meter square [8] , [9] , [10] , [11] .…”

“…Several studies have been published showing detailed data based on studies of medical charts of specific groups of patients [3] , [4] , [5] , [9] , [10] , [11] , [12] . To date, it is not known whether there has been progress in the degree of influence of prevalence of overweight/ obesity and vaccination rate on COVID-19 morbidity and mortality.…”

Respiratory and nonrespiratory COVID-19 complications in patients with obesity: recent developments

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