Obesity is risk factor for COVID-19 hospital admission in patients under 60

Obesity is associated with admission to the hospital for coronavirus disease 2019 (COVID-19) patients, according to a study published online April 9 in Clinical Infectious Diseases and a study not yet peer reviewed and posted on medRxiv.org.

Jennifer Lighter, M.D., from the NYU School of Medicine/NYU Langone Health in New York City, and colleagues conducted a retrospective analysis of body mass index (BMI) stratified by age in symptomatic patients who were positive for COVID-19 during March 4 to April 4, 2020. The researchers found that 21 percent of the 3,615 individuals who tested positive for COVID-19 had a BMI of 30 to 34 kg/m² and 16 percent had a BMI ≥35 kg/m². Among patients aged <60 years, those with a BMI of 30 to 34 kg/m² were 2.0 and 1.8 times more likely to be admitted to acute and critical care, respectively, while those with a BMI of ≥35 kg/m² were 2.2 and 3.6 times more likely to be admitted, respectively, compared with those with a BMI <30 kg/m².

Christopher M. Petrilli, M.D., from the NYU Grossman School of Medicine in New York City, and colleagues conducted a cross-sectional analysis of 4,103 patients with laboratory-confirmed COVID-19 treated at an academic health system between March 1 and April 2, 2020. The researchers found that the strongest risks for hospitalization were age ≥75 years, age 65 to 74 years, BMI >40 kg/m², and heart failure (odds ratios, 66.8, 10.9, 6.2, and 4.3, respectively). The most important factors in the decision tree for admission were age >65 years and obesity.

"It is notable that the chronic condition with the strongest association with critical illness was obesity, with a substantially higher odds ratio than any cardiovascular or pulmonary disease," Petrilli and colleagues write.