Impact Of Obesity On Illness Severity In Patients With Covid-19

INTRODUCTION: An emerging body of literature has shown an association between obesity and negative COVID-19 patient outcomes However, most of these studies have been limited in scale and are not focused on hospitalized patients Our study aims to report characteristics and outcomes associated with obesity in a large cohort of COVID-19 patients who were admitted during the peak of this pandemic METHODS: We performed a retrospective single center study at a large tertiary care hospital All index admissions of adult patients with confirmed COVID-19 between 3/1 and 4/30/2020 were included A manual chart review was performed to collect data on baseline patient characteristics, medical comorbidities, and clinical outcomes Patients were stratified into obese and non-obese cohorts for comparison SAS 9 4 was used for analysis RESULTS: A total of 1983 patients met our inclusion criteria of which 1031 (51 9%) were obese and 952 (48 9%) were non-obese Table 1 shows differences in baseline characteristics between these cohorts Obese patients were younger (58 2 vs 69 9;P < 0 001), more likely to be female (55% vs 45%;P < 0 001) and a higher proportion were African American (66% vs 52%;P < 0 001) compared to non-obese patients Obese patients were also more likely to be diabetic (41% vs 35%;P = 0 01) and have obstructive sleep apnea (15% vs 5%;P < 0 001) and less likely to have cardiovascular disease (25% vs 33%;P < 0 01) and malignancy (5% vs 10%;P < 0 01) (Table 2a) Obese patients were found to have lower overall mortality compared to non-obese patients (15% vs 25%;P < 0 001) however a logistic regression model revealed that this mortality difference was no longer significant when adjusted for patient age (OR 1 05, P = 0 685) This age-adjusted model also demonstrated increased odds of ICU admission (OR 1 39, P = 0 0044) and intubation (OR 1 40, P = 0 0096) in obese patients (Table 2b) There was a strong negative correlation (r2 = 0 2076, P < 0 001) between BMI and age among patients requiring ICU admission (Figure 1) CONCLUSION: Our study suggests that obesity may predispose younger patients with COVID-19 to be hospitalized for their illness Although obese patients do not have an increased mortality rate, they are at higher risk for requiring ICU admission and intubation during their hospital stay Recognizing that obesity impacts morbidity in this manner allows medical providers to triage and manage these patients more effectively earlier in their clinical course (Table Presented)