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Outcomes in Patients with Overweight and Obesity Hospitalized with COVID-19: An International, Multi-Center Retrospective Analysis
Posted: 20 Oct 2020
More...Abstract
Background: Obesity and commonly associated comorbidities, including diabetes and cardiovascular disease, have been associated with COVID-19 severity and mortality. Most studies are single jurisdiction and the association of obesity with in-hospital respiratory support and outcome remains unclear.
Methods: We retrospectively extracted data from health care records and regional databases of hospitalized SARS-CoV-2 patients from 69 hospitals (18 sites) in 11 countries. Standardized definitions and analyses were used to generate site-specific estimates, modelling the odds of each outcome (supplemental oxygen/non-invasive ventilation, invasive mechanical ventilation, and in-hospital mortality) by body mass index (BMI) category (reference, overweight, obese) adjusting for age, sex, and pre-specified co-morbidities. Site-specific estimates were combined in a meta-analysis.
Results: Among 7244 patients (65·6% overweight/obese), those with obesity were more likely to require oxygen/non-invasive ventilation (random effects adjusted odds ratio (AOR) 1·75; 95% confidence interval [CI], 1·33 to 2·30; P<0·001) and invasive mechanical ventilation (AOR 1·73; 95%CI, 1·29 to 2·32; P<0·001). Similar, but less pronounced effects were observed in those with overweight BMI. The association between obesity and in-hospital mortality was not statistically significant (AOR 1·23; 95%CI, 0·92 to 1·64; P=0·17). Among the co-variables, males had increased risk of all outcomes, and age >65 years was associated with increased oxygen/non-invasive ventilation requirement and in-hospital mortality. Cardiovascular disease and diabetes were associated with COVID-19 severity, independent of BMI.
Conclusions: Overweight and obesity were independently associated with need for respiratory support in COVID-19 patients. These findings inform individual-level risk stratification, management and health system planning for these high-risk groups.
Funding Statement: None.
Declaration of Interests: None.
Ethics Approval Statement: The study was conducted in accordance with Good Clinical Practice guidelines, local regulations, and the ethical principles described in the Declaration of Helsinki. Ethical approval was obtained at the co-ordinating centre (Murdoch Children’s Research Institute (MCRI), Royal Children’s Hospital, Melbourne, Australia, HREC 63887) and local approvals were obtained at participating sites, depending on local regulations. Informed consent was not required.
Suggested Citation: Suggested Citation
Graham Colditz
University College Dublin (UCD) - St Vincent’s Hospital
Belfield
Belfield, Dublin 4 4
Ireland
