Sex-specific impact of severe obesity in the outcomes of hospitalized patients with COVID-19: a large retrospective study from the Bronx, New York

Eur J Clin Microbiol Infect Dis. 2021 Sep;40(9):1963-1974. doi: 10.1007/s10096-021-04260-z. Epub 2021 May 6.

Abstract

It has been demonstrated that obesity is an independent risk factor for worse outcomes in patients with COVID-19. Our objectives were to investigate which classes of obesity are associated with higher in-hospital mortality and to assess the association between obesity and systemic inflammation. This was a retrospective study which included consecutive hospitalized patients with COVID-19 in a tertiary center. Three thousand five hundred thirty patients were included in this analysis (female sex: 1579, median age: 65 years). The median body mass index (BMI) was 28.8 kg/m2. In the overall cohort, a J-shaped association between BMI and in-hospital mortality was depicted. In the subgroup of men, BMI 35-39.9 kg/m2 and BMI ≥40 kg/m2 were found to have significant association with higher in-hospital mortality, while only BMI ≥40 kg/m2 was found significant in the subgroup of women. No significant association between BMI and IL-6 was noted. Obesity classes II and III in men and obesity class III in women were independently associated with higher in-hospital mortality in patients with COVID-19. The male population with severe obesity was the one that mainly drove this association. No significant association between BMI and IL-6 was noted.

Keywords: COVID-19; IL-6; Inflammation; Mortality; Novel coronavirus; Obesity; Observational study; Risk factor; SARS-CoV-2.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • COVID-19 / complications
  • COVID-19 / epidemiology
  • COVID-19 / mortality
  • COVID-19 / therapy*
  • Female
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / mortality
  • Obesity, Morbid / therapy*
  • Retrospective Studies
  • Sex Factors
  • Treatment Outcome