Obese COVID-19 patients face a greater risk of in-hospital death, mechanical ventilation

Obese individuals are more likely to be hospitalized for COVID-19, according to new findings published in Circulation. Obesity was also linked to higher rates of in-hospital mortality and mechanical ventilation.

The analysis included data from the American Heart Association’s COVID-19 Cardiovascular Disease Registry. More than 7,500 patients from 88 different U.S. hospitals were included in the study.

When categorizing individuals by their BMI, normal weight was defined as a BMI of 18.5-24.9 kg/m2. Overweight was defined as a BMI of 25-29.9 kg/m2, class 1 obesity was a BMI of 30-34.9 kg/m2, class II obesity was a BMI of 35-39.9 kg/m2 and class III obesity was a BMI of more than 40 kg/m2.

Overall, the authors found that obese patients were “overrepresented” in the registry of hospitalized in COVID-19 patients when compared to the U.S. population. The in-hospital mortality rate of the entire cohort was 17.1% and mechanical ventilation rate was 21.1%. After making adjustments for age, sex and other variables, class I, II and III obesity were all associated with a greater risk of in-hospital mortality or mechanical ventilation. Also, the association between BMI and death or mechanical ventilation was its most significant among patients 50 years old or younger. The associations were weakest among patients over the age of 70 years old.

After making adjustments, a high BMI was also linked to dialysis initiation and venous thromboembolism.

The team also noted that, looking at unadjusted models, overweight and obese patients were at a lower risk of experiencing a major adverse cardiovascular event (MACE). Once making adjustments, however, “there was  no association between obesity classes and MACE.”  

“These observations support rigorous adherence to COVID-19 prevention strategies in obese individuals of all ages,” wrote lead author Nicholas S. Hendren, MD, University of Texas Southwestern Medical Center in Dallas, and colleagues. “Clear public health messaging is needed for younger obese individuals who may underestimate their risk of severe COVID-19.”

The study can be read here.