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Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection : A Retrospective Cohort Study
Michaela R Anderson1, Joshua Geleris1, David R Anderson2
1Columbia University Irving Medical Center, New York, New York (M.R.A., J.G., J.Z., Y.R.N., D.F., J.S., K.N.R., S.C., K.N., D.R., E.E., A.P., A.W.F., M.R.B.).
Annals of Internal Medicine
|July 30, 2020
Summary
Obesity increases the risk of intubation or death in COVID-19 patients under 65. This association was not observed in older adults, highlighting age as a critical factor in obesity-related COVID-19 outcomes.
Area of Science:
- Medical Research
- Epidemiology
- Public Health
Background:
- Obesity is a known risk factor for pneumonia and acute respiratory distress syndrome.
- Investigating the impact of obesity on severe outcomes in COVID-19 is crucial for patient management.
Purpose of the Study:
- To determine if obesity is associated with intubation, death, inflammation, cardiac injury, or fibrinolysis in COVID-19 patients.
- To analyze the relationship between body mass index (BMI) and severe COVID-19 outcomes.
Main Methods:
- Retrospective cohort study of 2466 adults hospitalized with COVID-19.
- Analysis included body mass index (BMI), inflammation markers (CRP, ESR), cardiac injury (troponin), and fibrinolysis (D-dimer).
- Primary endpoint was a composite of intubation or death, analyzed using time-to-event methods.
Main Results:
- Patients with obesity, particularly class 3, had a higher risk of intubation or death compared to overweight individuals.
- This association was significant in patients younger than 65 but not in those aged 65 or older.
- BMI was not associated with admission levels of inflammation, cardiac injury, or fibrinolysis biomarkers.
Conclusions:
- Obesity is linked to an increased risk of intubation or death from COVID-19 in adults under 65.
- Age modifies the association between obesity and severe COVID-19 outcomes.
- Findings emphasize the importance of considering age in the context of obesity and COVID-19 severity.
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