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Introduction: Obesity may affect COVID-19 outcomes, independent of its association with hypertension, diabetes, chronic obstructive pulmonary disease and other cardiovascular disease. Hypothesis: Is obesity a major determinant of morbidity and mortality in patients with COVID-19? Methods: Retrospective analysis of all confirmed COVID-19 patients hospitalized at University Medical Center in New Orleans, Louisiana between February 1, 2020 to May 1, 2020 was performed. Intensive care unit (ICU) stay and fatal outcomes were analyzed as a function of body mass index (BMI), hypertension, diabetes, hyperlipidemia, and CKD. Risk factors for fatal outcomes were evaluated. Multivariate logistic regression was used to determine odds ratios. P-Value was set at 0.05. Results: From a sample size of 419 patients, 60(14.3%) were admitted to the ICU. Amongst ICU admits, 85% were African American (AA), 61.6% had BMI >30, 48.3% had diabetes, and 30% had chronic kidney disease. Mortality was 91.6% after ICU admission. Out of a total of 419, mortality was the highest in admits with BMI < 25(20.2%) and with BMI >40(20.3%). BMI > 40 was associated with a higher odds of death (Odds ratio: 3.9, 95% Confidence Interval (CI) 1.45-10.5) and ICU admission (OR:3.2 95% CI 1.1-9) after adjustment for age, race, sex and comorbidities. Conclusion: A direct association exists for BMI > 40 and in-hospital death, independent of comorbidities. Caution with aggressive intervention is warranted for such patients on presentation.

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