Association of body mass index with severity and mortality of COVID-19 pneumonia: a two-center, retrospective cohort study from Wuhan, China

Xiaodong Wu, Chenghong Li, Shi Chen, Xin Zhang, Feilong Wang, Ting Shi, Qiang Li, Lin Lin

Research output: Contribution to journalArticlepeer-review

Abstract

In this study, we aimed to investigate the relationship between body mass index (BMI) and multiple severe outcomes of the coronavirus disease 2019 (COVID-19) pneumonia. A total of 1091 patients hospitalized with COVID-19 pneumonia were included from Wuhan, China. Overall, 2.8% (n = 31) received invasive mechanical ventilation (IMV), 10.8% (n = 118) were admitted to the intensive care unit (ICU), 6.4% (n = 70) developed acute respiratory distress syndrome (ARDS), and 4.4% (n = 48) died. Multivariable-adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) of IMV therapy, ICU admission and ARDS associated with obesity were 2.86 (1.16-7.05), 2.62 (1.52-4.49) and 3.15 (1.69-5.88), respectively; underweight was significantly associated with death (HR 3.85, 95%CI 1.26-11.76). Restricted cubic spline analyses suggested U-shaped associations of BMI with ICU admission and death, but linear relationships of BMI with IMV therapy and ARDS. In conclusion, obesity had an increased risk of IMV therapy, ICU admission and ARDS, while underweight was associated with higher mortality in COVID-19 pneumonia. U-shaped associations of BMI with ICU admission and death, and linear relationships of BMI with IMV therapy and ARDS, were found. These findings indicate that extra caution should be taken when treating COVID-19 patients with underweight and obesity.

Original languageEnglish
Pages (from-to)7767-7780
Number of pages14
JournalAging
Volume13
Issue number6
DOIs
Publication statusPublished - 24 Mar 2021

Keywords

  • Body Mass Index
  • COVID-19/physiopathology
  • China
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Respiration, Artificial
  • Respiratory Distress Syndrome/therapy
  • Retrospective Studies
  • SARS-CoV-2/isolation & purification
  • Severity of Illness Index

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