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/m2), patients with normal weight (BMI 18.5-24.9 kg/m2), patients with overweight (BMI 25-29.9 kg/m2), and patients with obesity (BMI ≥ 30 kg/m2). 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.
ABSTRACT
Objective: The rapid emergence of the SARS-COV2 virus that caused COVID-19 pandemic in early 2020 led to authorities instituting lockdown protocols to curb spread of the virus. Prior studies in patients with T1DM have demonstrated a short-term favorable or neutral effect of the lockdown on glycemic parameters;however, data is limited in T2DM patients. We sought to identify how the lockdown affected the glycemic control of adult patients with T2DM within a specific region of New York Design & Methods: In this retrospective cohort study, we analyzed data from patients with regular outpatient visits within an integrated-delivery health system in South Bronx, New York who had A1C levels measured within 6 months prior to the initiation of lockdown (Mar '20) and a repeat A1C within 3 months after the first phase of reopening in New York (June '20). Analysis of comparison between pre- and post-lockdown HbA1c values was performed using paired samples T-test. Results: A total of 2489 adult patients with an established diagnosis of T2DM and A1C levels available during the study period were identified. 632 patients were excluded due to pregnancy, prediabetes, new-onset diabetes, residency in long-term care facility or hospital admission during the study period. Age range was 18 to 95 years with a mean age of 61. 58% of the patients were female and 41% male. Mean pre-lockdown A1C was 7.64% and mean post-lockdown A1C was 7.76%, indicating an increase of 0.122% (95% CI, 0.0613-0.1827) Conclusions: The COVID-19 lockdown was associated with a small but statistically significant increase in HbA1C levels (0.122%) in a large cohort of community-dwelling adult patients with type 2 diabetes in South Bronx. Interruptions to regular outpatient care, difficulty in obtaining medications from pharmacies, changes in physical activity or diet and psychological stress related to the pandemic may have been potential contributing factors and need to be addressed to avoid further worsening of diabetes control in the longer term.