Does obesity raise mortality risk in COVID-19 patients?

Obesity does not appear to elevate the risk of death in critically ill patients with COVID-19, results of a study have shown. In addition, patients with BMI <25 kg/m2 have a higher rate of mortality than those with greater BMI levels. 

Individuals aged 18 years and above who had been admitted to the intensive care unit with SARS-CoV-2 were included in this multicentric, retrospective cohort study. The authors obtained data from electronic medical records and performed multiple logistic regression and restricted cubic splines analyses to explore the relationship between mortality and BMI. In-hospital death was the primary outcome. 

A total of 977 patients met the eligibility criteria from March 2020 to December 2021. Of these, 868 were included in the final analysis. 

Less than half of the included patients had obesity (n=383, 44 percent). Patients with obesity were more likely to undergo prone positioning (42 percent vs 28 percent; p<0.001), but they were less likely to use vasoactive medications (57 percent vs 68 percent; p<0.001). 

In-hospital mortality stood at 48 percent, with 44 percent seen in the subgroup of individuals with obesity and 50 percent in those who were not obese (p=0.06). The highest mortality rate was observed among patients with BMI <25 kg/m2. 

“Obesity was not associated with higher mortality rates in critically ill patients with COVID-19,” the authors said.