Takeaway
- Body mass index (BMI) demonstrated a J-shaped association with the risk of COVID-19-related hospitalisation and death and a linear association with intensive care unit (ICU) admissions.
- This risk was more pronounced in younger adults aged <40 years and people of Black ethnicity.
Why this matters
- Findings highlight the association of excess weight with severe COVID-19 outcomes, which may help inform priority populations for COVID-19 vaccinations.
Study details
- This prospective, community-based cohort study used de-identified patient-level data from the QResearch database of general practices in England.
- Data were acquired for 6,910,695 individuals (mean BMI, 26.78 kg/m2) aged between 20 and 99 years.
- Funding: National Institute for Health Research Oxford Biomedical Research Centre.
Key results
- Overall, COVID-19 was attributed to 13,503 hospitalisations, 1601 ICU admissions and 5497 deaths.
- Each BMI unit increase of above 23 kg/m2 was associated with an increased risk of:
- hospital admissions (adjusted HR [aHR], 1.05; 95% CI, 1.05-1.05);
- ICU admissions (aHR, 1.10; 95% CI, 1.09-1.10); and
- death (aHR, 1.04; 95% CI, 1.04-1.05).
- These outcomes were independent of existing co-morbidities, including type 2 diabetes.
- The risk of severe COVID-19 outcomes per unit BMI increase was highest in younger adults and decreased with increasing age (P<.0001):
- In people aged 20-39 years, each BMI unit increase above 23 kg/m2 was associated with an elevated risk of COVID-19-related hospitalisation (aHR, 1.09; 95% CI, 1.08-1.10), ICU admission (aHR, 1.13; 95% CI, 1.11-1.16) and death (aHR, 1.17; 95% CI, 1.11-1.23).
- People of Black vs White ethnicity had a higher risk (P<.0001) of COVID-19-related hospitalisation and death, but not of ICU admission.
Limitations
- Observational design.
- Fewer people had recent BMI measurements.
- Possibility of chance findings cannot be excluded.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
