Obesity and Risk for Intubation or Death from COVID-19 [COVID-19 and Physical Activity Series]
Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection by Dr. Anderson and co-authors is a retrospective cohort study. Data from 2,466 adults hospitalized with SARS-CoV-2 infection between March 10th and April 24th at New York-Presbyterian/Columbia University Irving Medical Center and Allen Hospital were analyzed. Patients’ median age was 67 years, median BMI was 27.9 kg/m2, and median number of comorbid conditions was two. Dr. Anderson and co-authors concluded that obesity is associated with increased risk for intubation or death from COVID-19 in adults younger than 65 years, but not in adults aged 65 years or older. Specifically, compared with overweight patients, patients with BMI of 40 kg/m2 or higher had the highest risk for intubation or death (hazard ratio, 1.6 [95% CI, 1.1 to 2.1]). Moreover, the link between obesity and worse outcomes was strongest among patients aged younger than 65 years (p for interaction by age = .042). Dr. Anderson and co-authors also found that obesity is associated with intubation or death independent of several comorbid conditions (e.g., diabetes and hypertension). They posited that the absence of an association between obesity and intubation or death in older adults may reflect a high mortality due to comorbidity, frailty, or worse immune function with older age. These findings might inform discussions between health care providers and patients regarding advanced care planning and benefits of prolonged social distancing, particularly for younger adults with class 2 or 3 obesity.
Anderson, M. R., Geleris, J., Anderson, D. R., Zucker, J., Nobel, Y. R., Freedberg, D., ... & Natarajan, K. (2020). Body mass index and risk for intubation or death in SARS-CoV-2 infection: a retrospective cohort study. Annals of internal medicine.
