Obesity and the obesity paradox in patients with severe COVID-19

Abstract

ObjectiveTo test the presence of the obesity paradox in two cohorts of patients hospitalized for COVID-19. DesignTwo multicenter prospective cohorts. SettingThree fourth level institutions. PatientsAdults hospitalized in the general ward for confirmed COVID-19 in the three institutions and those admitted to one of the 9 critical care units of one of the institutions. InterventionsNone. Main variables of interestCategorized weight and its relationship with admission to the ICU in hospitalized patients and death in the ICU. ResultOf 402 hospitalized patients, 30.1% were obese. Of these, 36.1% were admitted to the ICU vs. 27.1% of non-obese patients. Of the 302 ICU patients, 46.4% were obese. Of these, mortality was 45.0% vs. 52.5% for non-obese. The requirement to transfer hospitalized patients to the ICU admission get a HR of 1.47 (95%CI 0.87–2.51, p = 0.154) in the multivariate analysis. In intensive care patients, an HR of 0.99 (95%CI: 0.92–1.07, p = 0.806) was obtained to the association of obesity with mortality. ConclusionsThe present study does not demonstrate an association between obesity and risk of inpatient transfer to intensive care or death of intensive care patients due to COVID-19 therefore, the presence of an obesity paradox is not confirmed.