Obesity and Outcomes in Patients with Covid-19: A Retrospective Review from a Community Hospital

Abstract

RationaleThe novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as one of the greatest challenges in modern medicine. As the pandemic has progressed throughout the globe it has revealed vulnerable populations;one of these being obese patients. Obesity has been associated with an increased risk of hospitalization along with other co-morbid conditions such as hypertension, diabetes, cardiovascular disease and chronic lung disease. We sought to investigate the mortality associated with COVID-19 positive obese patients in the inpatient setting. MethodsThis observational retrospective study included patients who were admitted to the hospital with confirmed SARS-CoV-2 RNA qualitative polymerase chain reaction assay from March 1, 2020 until May 20, 2020. The primary outcome of this study was the mortality of patients who were admitted to the hospital. Other outcomes included: hospital length of stay, need for intensive care, mechanical ventilation, continuous renal replacement therapy and secondary bacterial infection. Primary Statistical analysis of data was performed using Microsoft Excel and R 4.0.2. Quantitative variables were compared using a t-test and categorical variables with chi-squared testing. Time to event analysis was evaluated with a log-rank test. ResultsAmong the 178 patients hospitalized COVID-19 positive patients, the average BMI was 28.90 (SD 6.48). There were 40 in hospital deaths with an average BMI of those alive 28.80 (SD 6.16) and among those who expired of 29.26 (SD 7.56). Multivariate logistic regression of the full variable model of mortality demonstrated that age, intensive unit care, mechanical ventilation and days of hospitalization were statistically significant and correlated with mortality (p-values 0.007, 0.031, 0.020, and 0.0001). Kaplan Meier analysis comparing obese and non obese individuals to number of days of hospitalization until time of death with censoring demonstrated an absence of statistically significant difference (p-value 0.696). Backward stepwise reduction of the multivariate linear regression model demonstrated multivariate statistical significance for age (pvalue 1.58 E -09), gender (p-value 0.01), hypertension (p-value 0.003), and smoking status (p-value 0.005). Conclusion Advanced age, intensive care, mechanical ventilation and days of hospitalization increased the risk of mortality. We also confirmed that hypertensive and patients with a history of smoking also had an increased risk of mortality.