Obesity Biggest Risk for COVID-19 Pneumonia, After Age, Male
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In a large international study of patients admitted to the intensive care unit (ICU) with COVID-19, the likelihood of having severe pneumonia (ie, needing invasive mechanical ventilation) increased stepwise with increasing body mass index (BMI) — independent of diabetes, hypertension, dyslipidemia, or current smoking.

Previous studies unveiled a relation between COVID-19 severity and obesity. The aims of this multicenter retrospective cohort study were to disentangle the association of body mass index (BMI) and associated metabolic risk factors, with pneumonia outcomes in critically ill patients with COVID-19, and explore the impact of age and sex on this relationship.

Participants were COVID-19 patients admitted in intensive care in 21 centers. The exposure of interest was BMI. The primary and secondary outcomes were the need for invasive mechanical ventilation (IMV), and 28-day mortality. The covariates were age, sex, and diabetes, hypertension, hyperlipidemia, and current smoking.

Researchers enrolled 1,461 patients (median age 64 years; 73.2% males; median BMI 28.1 kg/m2); 1,080 patients (73.9%) required IMV and the 28-day mortality rate was 36.1%.

Adjusted mixed logistic regression model showed a significant relation between BMI and IMV: odds ratio 1.27 per 5 kg/m2 in the whole cohort, and 1.65 per 5 kg/m2 in females under 50 years. Adjusted Cox proportional hazards regression model showed a significant association between BMI and mortality, which was only increased in obesity class III (greater than 40 kg/m2).

Conclusively, they observed in critically ill COVID-19 patients, a linear association between BMI and the need for IMV, independent of other metabolic risk factors, and more pronounced in younger females, and a non-linear association between BMI and mortality risk.

Source: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3667634