BMI as a Risk Factor for Clinical Outcomes in Patients Hospitalized with COVID-19 in New York.

OBJECTIVE: This study examined the association between BMI and clinical outcomes among patients with coronavirus disease 2019 (COVID-19) infection. METHODS: A total of 10,861 patients with COVID-19 infection who were admitted to the Northwell Health system hospitals between March 1, 2020, and April 27, 2020, were included in this study. BMI was classified as underweight, normal weight, overweight, and obesity classes I, II, and III. Primary outcomes were invasive mechanical ventilation (IMV) and death. RESULTS: A total of 243 (2.2%) patients were underweight, 2,507 (23.1%) were normal weight, 4,021 (37.0%) had overweight, 2,345 (21.6%) had obesity class I, 990 (9.1%) had obesity class II, and 755 (7.0%) had obesity class III. Patients who had overweight (odds ratio [OR] = 1.27 [95% CI: 1.11-1.46]), obesity class I (OR = 1.48 [95% CI: 1.27-1.72]), obesity class II (OR = 1.89 [95% CI: 1.56-2.28]), and obesity class III (OR = 2.31 [95% CI: 1.88-2.85]) had an increased risk of requiring IMV. Underweight and obesity classes II and III were statistically associated with death (OR = 1.44 [95% CI: 1.08-1.92]; OR = 1.25 [95% CI: 1.03-1.52]; OR = 1.61 [95% CI: 1.30-2.00], respectively). Among patients who were on IMV, BMI was not associated with inpatient deaths. CONCLUSIONS: Patients who are underweight or who have obesity are at risk for mechanical ventilation and death, suggesting that pulmonary complications (indicated by IMV) are a significant contributor for poor outcomes in COVID-19 infection.

Analysis of Mortality and Morbidity in COVID-19 Patients with Obesity Using Clinical Epidemiological Data from the Korean Center for Disease Control & Prevention.

Previous studies have reported the association of obesity with increased morbidity or mortality due to the coronavirus disease 2019 (COVID-19). This study aims to investigate the relationship of obesity, as defined by the body mass index (BMI), with morbidity and mortality due to COVID-19. Data from 5628 confirmed COVID-19 patients were collected by the Centers for Disease Control and Prevention of Korea. The hazard ratios (HRs) for mortality in the BMI groups were analyzed using the Cox proportional hazard model adjusted for covariates. The odds ratios (ORs) of morbidity and diabetes in the BMI groups were analyzed using logistic regression adjusted for the same covariates. Both underweight and obesity were associated with a higher HR for mortality (adjusted HR = 2.28, 95% confidence intervals [95% CI] = 1.23-4.25, p = 0.009 for underweight and adjusted HR = 1.71, 95% CI = 1.10-2.66, p = 0.017 for obese). Obesity was related to higher odds of morbidity (adjusted OR = 1.71, 95% CI = 1.32-2.21, p < 0.001). Underweight and obesity were associated with high mortality and/or morbidity due to COVID-19 in Korea.