Association of obesity with illness severity in hospitalized patients with COVID-19: A retrospective cohort study

Obes Res Clin Pract. 2021 Mar-Apr;15(2):172-176. doi: 10.1016/j.orcp.2021.02.006. Epub 2021 Feb 25.

Abstract

Background: Although recent studies have shown an association between obesity and adverse coronavirus disease 2019 (COVID-19) patient outcomes, there is a paucity in large studies focusing on hospitalized patients. We aimed to analyze outcomes associated with obesity in a large cohort of hospitalized COVID-19 patients.

Methods: We performed a retrospective study at a tertiary care health system of adult patients with COVID-19 who were admitted between March 1 and April 30, 2020. Patients were stratified by body mass index (BMI) into obese (BMI ≥ 30 kg/m 2) and non-obese (BMI < 30 kg/m 2) cohorts. Primary outcomes were mortality, intensive care unit (ICU) admission, intubation, and 30-day readmission.

Results: A total of 1983 patients were included of whom 1031 (51.9%) had obesity and 952 (48.9%) did not have obesity. Patients with obesity were younger (P < 0.001), more likely to be female (P < 0.001) and African American (P < 0.001) compared to patients without obesity. Multivariable logistic models adjusting for differences in age, sex, race, medical comorbidities, and treatment modalities revealed no difference in 60-day mortality and 30-day readmission between obese and non-obese groups. In these models, patients with obesity had increased odds of ICU admission (adjusted OR, 1.37; 95% CI, 1.07-1.76; P = 0.012) and intubation (adjusted OR, 1.37; 95% CI, 1.04-1.80; P = 0.026).

Conclusions: Obesity in patients with COVID-19 is independently associated with increased risk for ICU admission and intubation. Recognizing that obesity impacts morbidity in this manner is crucial for appropriate management of COVID-19 patients.

Keywords: COVID-19; Coronavirus; Hospitalization; ICU; Mortality; Obesity.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • COVID-19 / epidemiology*
  • COVID-19 / therapy
  • Comorbidity
  • Female
  • Hospital Mortality
  • Hospitalization*
  • Humans
  • Intensive Care Units*
  • Intubation
  • Logistic Models
  • Male
  • Middle Aged
  • Obesity / epidemiology*
  • Obesity / ethnology
  • Odds Ratio
  • Patient Readmission
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index*
  • Sex Factors