ABSTRACT
Background: COVID-19 has been identified as a risk factor for coagulopathy leading to increased risk of venous thromboembolic events (VTE). However, the risk profile of VTE in patients with obesity -a patient population with higher risk for VTE at baseline -is poorly described. The aim of this study is to determine if obesity and BMI is associated with increased rates of VTE in patients hospitalized with COVID-19. Methods: Patients admitted with confirmed Sars-CoV- 2 infections from November 2020-January 2021 were examined. Patients were excluded if they were minors, currently pregnant, or if their COVID-diagnosis was an incidental finding in the setting of an unrelated admission -i. e. penetrating trauma. Imaging results were used to verify VTE related patient outcomes, pulmonary embolisms (PE) and deep vein thrombosis (DVT). COVID-19 specific anticoagulation regimes looking at standard, intensive, and therapeutic anticoagulation were examined. Results: Of 1505 patients included in the study, 754 (50%) had BMI < 30kg/m2 and 751 (50%) had BMI >30kg/m2. DVTs occurred in 40 (2.66%) patients, with no differences in incidence between those with and without obesity (2.40% vs 2.92%;p = 0.53). PEs occurred in 35 (2.33%) of patients, with no differences in incidence between those with and without obesity (2.40% vs. 2.25%;p = 0.85). No significant differences existed in the initial intensity (p = 0.50) of anticoagulation regimen or maximum intensity (p = 0.27) between those with and without obesity. In multivariate logistic regression adjusting for age, sex, race, prior history of venous thromboembolic events, use of antiplatelet medications, and intensive care unit admission, BMI was not associated with increased odds of experiencing a DVT (OR = 0.978;95% CI 0.934, 1.024;p = 0.348) or PE (OR = 1.005;95% CI 0.959, 1.052;p = 0.849). Conclusions: Patients with obesity hospitalized for COVID-19 were not at higher risk for thromboembolic events, such as DVTs and PEs, compared to patients without obesity.