Obesity ups risk for intubation, death with COVID-19 in adults under 65

(HealthDay)—Obesity is associated with an increased risk for intubation or death among hospitalized adults with COVID-19, with the association observed in adults younger than 65 years but not in older adults, according to a study published online July 29 in the Annals of Internal Medicine.

Michaela R. Anderson, M.D., from the Columbia University Irving Medical Center in New York City, and colleagues examined whether obesity is associated with intubation or death, inflammation, cardiac injury, or fibrinolysis in COVID-19 in a retrospective cohort study. Data were included from 2,466 adults hospitalized with severe acute respiratory syndrome coronavirus 2 infection during a 45-day period.

The researchers found that 22 percent of patients were intubated, 25 percent died, and 2 percent remained hospitalized during a median hospital length of stay of seven days. Patients with obesity had an increased risk for intubation or death compared with overweight patients, with the risk highest for class 3 obesity (hazard ratio, 1.6). The association was mainly seen for patients aged younger than 65 years and not in older patients. There was no association noted for body mass index with admission levels of biomarkers of inflammation, cardiac injury, or fibrinolysis.

"Additional investigations should evaluate potential mechanisms linking obesity and respiratory failure in COVID-19, including the role of specific inflammatory cytokines, complement-mediated endothelial cell dysfunction and thrombosis, and chest wall mechanics," the authors write.