Body Mass Index and Clinical Outcomes in Adult COVID-19 Patients of Diverse Ethnicities

Abstract

(1) Background: Body mass index (BMI) was observed to affect COVID-19 outcomes; however, the complete spectrum of clinical outcomes concerning BMI remains unexplored. The current study aimed to investigate the correlation between BMI and the severity and mortality of COVID-19, as well as ICU admission, radiological findings, clinical presentation, and time to viral clearance. (2) Methods: This retrospective study included 1796 multiethnic patients with COVID-19 treated at NMC Royal Hospital, Abu Dhabi, UAE. (3) Results: COVID-19’s adjusted odds of severity increased by 3.7- and 21.5-fold in classes I and III, respectively (p = 0.001). The odds of mortality were not significantly different after adjustment for age, sex, and race. The adjusted odds of ICU admission increased significantly by 3-fold and non-significantly by 4-fold in obesity classes I and II, respectively. Pneumonia was significantly higher in patients who were overweight and class I, II, and III obese. Furthermore, class III obese patients had a greater risk of presenting with combined respiratory and gastrointestinal manifestations (p < 0.001). The median time to viral clearance with a BMI > 40 kg/m2 was moderately higher than that with a BMI < 40 kg/m2. (4) Conclusions: High BMI was associated with pneumonia, ICU admission, severity, and mortality due to COVID-19.

Adipokines as Diagnostic and Prognostic Markers for the Severity of COVID-19

“…This observation was recently confirmed in a meta-analysis of 34,390 patients from 12 different studies identifying the association of obesity with poor outcome, mortality, and severity in COVID-19 patients [12]. Likewise, several other studies identified obesity as a risk factor for worse disease outcomes of COVID-19, suggesting that higher BMI may be useful for risk stratification [13][14][15].…”

“…Obesity increases the susceptibility and risk for SARS-CoV-2 infections, a worse COVID-19 disease trajectory and COVID-19-related death [13]. Circulating levels of chemerin, leptin, and galectin-3 are commonly elevated, while serum adiponectin levels are reduced in the obese and all of those changes are related to metabolic diseases (Figure 2) [5,28,43].…”

Association between Body Mass Index and Hospital Outcomes for COVID-19 Patients: A Nationwide Study

“…These results were in line with the study by Palaiodimos et al [ 11 ], which found that obesity leads to a four-fold increase in in-hospital mortality. Similarly, when comparing obese patients to a normal BMI range (20–29.9), a study conducted in the United Arab Emirates including 1796 by Hafez et al [ 12 ] showed a non-significant increase in mortality for patients with Class III obesity (BMI ≥ 40). Another study conducted in Japan by Lee et al [ 13 ], which included 1837 patients, did not show significant differences in morality among the BMI classes when compared to each other.…”

The association between obesity with treatment duration, ICU length of stay and the risk of death in critically ill patients with COVID‐19

“…5,6 Obesity, as a known risk factor for respiratory infections, was reported to be associated with unpleasant clinical outcomes in patients with COVID-19. 7,8 A systematic review of the studies on obesity and mortality of COVID-19 patients in the Asian and western countries reported that the mortality of COVID-19-hospitalized patients is related to obesity. 9 The exact mechanism of the effect of obesity on patients with COVID- 19 is not yet clear.…”