COVID-19: Impact of Obesity and Diabetes in Disease Severity

ABSTRACT

BackgroundThe Coronavirus disease 2019 (COVID-19) pandemic is straining the healthcare system, particularly for patients with severe outcomes who require admittance to the intensive care unit (ICU). This study aimed to investigate the potential associations of obesity and diabetes with COVID-19 severe outcomes, assessed as ICU admittance. SubjectsDemographic and patient characteristics from a retrospective cohort of 1158 patients hospitalized with COVID-19 in a single center in Kuwait, along with their medical history, were analyzed. Univariate and multivariate analyses were performed to explore the associations between different variables and ICU admittance. ResultsFrom the 1158 hospitalized patients, 271 (23.4%) had diabetes, 236 (20.4%) had hypertension and 104 (9%) required admittance into the ICU. From patients with available measurements, 157 (21.6%) had body mass index (BMI)[≥]25 kg/m2. Univariate analysis showed that overweight (BMI=25.0-29.9 kg/m2), obesity class I (BMI=30-34.9 kg/m2) and morbid obesity (BMI[≥]40 kg/m2) associated with ICU admittance (odds ratio (OR) [95% confidence intervals (CI)] 2.45 [1.26-4.74] p-value=0.008; OR [95% CI] 3.51 [1.60-7.69] p-value=0.002; and OR [95% CI] 5.18 [1.50-17.85] p-value=0.009], respectively). Patients with diabetes were more likely to be admitted to ICU (OR [95% CI] 9.38 [5.49-16.02]). Two models for multivariate regression analysis were used, assessing either BMI or diabetes on ICU outcomes. In the BMI model, class I obesity and morbid obesity were associated with ICU admittance (adjusted OR (AOR) [95% CI] 2.7 [1.17-6.20] p-value=0.019 and AOR [95% CI] 3.95 [1.00-15.20] p-value=0.046, respectively). In the diabetes model, diabetes was associated with higher ICU admittance (AOR [95% CI] 5.49 [3.13-9.65] p-value<0.001) whereas hypertension had a protective effect on ICU admittance (AOR [95% CI] 0.51 (0.28-0.91). ConclusionsIn our cohort, overweight, obesity and diabetes in patients with COVID-19 were associated with ICU admittance, putting these patients at higher risk of poor outcomes.