Is body mass index a risk factor in the clinical course of patients with Covid 19 pneumonia?

Abstract

Objective: Coronavirus disease 2019 (COVID-19)-related infections emerging from China that spread worldwide show a wide range of clinical courses from asymptomatic presentation to respiratory failure and even death. Similar to non-COVID-19 infections, obesity, age, and comorbidities can also affect the clinical course of the disease. This study aimed to investigate the effect of obesity on the clinical course and mortality of patients hospitalized with COVID-19 pneumonia. Methods: Between March 11 and April 30, 2020, patients hospitalized with COVID-19 pneumonia were retrospectively analyzed. Patients were classified as having severe and mild disease based on oxygen, non-invasive mechanical ventilation (NIMV), and invasive (IMV) mechanical ventilation requirements. Two groups were evaluated based on body mass index (BMI) of 25 and 30 kg/m2. Results: Of the 125 patients, 82 (65.6%) were men, and their mean age was 51.77+or-4.99 years. Their mean BMI was 27.76+or-4.76 kg/m2. The difference of the mean BMI between the patients with severe and mild disease was statistically significant (28.8+or-5.36 and 26.9+or-4.10, respectively) (p=0.028). BMI of 25 and 30 kg/m2 were noted in 43.4% and 20.8% of patients with severe and mild disease, respectively, which was statistically significant (p=0.007). Moreover, 70.6% of 17 patients older than 65 years with BMI of 25 kg/m2 had a severe clinical course (p=0.021). Among patients requiring NIMV, 59.1% and 31.8% had a BMI of 25 and 30 kg/m2, respectively. Among patients requiring IMV, 66.7% and 37.5% had a BMI of 25 and 30 kg/m2, respectively. No statistically significant difference was found between BMI and NIMV and IMV need. Death occurred in 14.8% of the patients. No statistically significant difference was found between the BMI of those who died and survived (p=0.768). Conclusion: Our study showed that overweight and obesity were important factors in assessing and predicting disease severity, and special care should be taken in the follow-up of patients with a BMI of 30 kg/m2.