Association between being underweight and excess body weight before SARS coronavirus type 2 infection and clinical outcomes of coronavirus disease 2019: Multicenter study.

ABSTRACT

OBJECTIVES: The present study aimed to identify associations between extremes in body weight status (underweight and excess body weight) before a COVID-19 diagnosis and clinical outcomes in patients infected with SARS coronavirus type 2. METHODS: A multicenter cohort study was conducted in eight different states in northeastern Brazil. Demographic, clinical (previous diagnosis of comorbidities), and anthropometric (self-reported weight and height) data about individuals who tested positive for COVID-19 were collected. Outcomes included hospitalization, mechanical ventilation, and death. Multivariable logistic regression models, adjusted based on age, sex and previous comorbidities, were used to assess the effects of extremes in body weight status on clinical outcomes. RESULTS: A total of 1308 individuals were assessed (33.6% were elderly individuals). The univariable analyses showed that only hospitalization was more often observed among underweight (3.2% versus 1.2%) and overweight (68.1% versus 63.3%) individuals. In turn, cardiovascular diseases were more often observed in all clinical outcomes (hospitalization 19.7% versus 4.8%; mechanical ventilation 19.9% versus 13.5%; death 21.8% versus 14.1%). Based on the multivariable analysis, body weight status was not associated with risk of hospitalization (underweight odds ratio [OR] 1.10; 95% confidence interval [CI] 95%, 0.50-2.41 and excess body weight OR 0.81; 95 CI, 0.57-1.14), mechanical ventilation (underweight OR 0.92; 95% CI, 0.52-1.62 and excess weight OR 0.90; 95% CI, 0.67-1.19), and death (underweight OR 0.61; 95% CI, 0.31-1.20 and excess body weight OR 0.88; 95% CI, 0.63-1.23). CONCLUSIONS: Being underweight and excess body weight were not independently associated with clinical outcomes in patients with COVID-19 in the herein analyzed cohort. This finding indicates that the association between these variables may be confounded by both age and comorbidities.