Body Mass Index as a Risk Factor for Clinical Outcomes in Patients Hospitalized with COVID-19 in New York.
OBJECTIVE:To examine the association between body mass indexes (BMI) and clinical outcomes among patients with COVID-19 infection. METHODS:We included 10,861 patients with COVID-19 infection admitted to the Northwell Health system hospitals during the period of March 1 to April 27, 2020. BMI was classified as: underweight, normal, overweight, obesity class I, II, and III. Primary outcomes are invasive mechanical ventilation (IMV) and death. RESULTS:There were 243 (2.2%) underweight, 2,507 (23.1%) normal weight, 4,021 (37.0%) overweight, 2,345 (21.6%) obesity class I, 990 (9.1%) obesity class II, and 755 (7.0%) obesity class III patients. Patients who are overweight (OR=1.27[95% CI, 1.11-1.46]), obesity class I (OR=1.48 [95% CI, 1.27-1.72]), obesity class II (OR=1.89[95% CI, 1.56-2.28]), and obesity class III (OR=2.31 [95% CI, 1.88-2.85]) had increased risk of requiring IMV. Underweight and obesity classes II and III were statistically associated with death (OR=1.44 [95% CI, 1.08-1.92]; OR=1.25 [95% CI 1.03-1.52]; OR=1.61 [95% CI 1.30-2.00], respectively). Among patients who were on IMV, BMI was not associated with inpatient deaths. CONCLUSION:Patients who are underweight or with obesity are at a risk for mechanical ventilation and death, suggesting pulmonary complications (indicated by IMV) is a significant contributor for poor outcomes in COVID-19 infection.
School of Medicine
General Internal Medicine