Physique mass index and extreme COVID-19

The COVID-19 pandemic has affected over 60 million folks worldwide, with practically 1.43 million succumbing to extreme COVID-19 illness, and practically 40 million recovered. COVID-19 illness attributable to extreme acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is extreme, resulting in life-threatening issues in a small proportion of people. A number of danger elements have been related to extreme COVID-19, amongst which weight problems is one.

French researchers led by first creator Abdallah Al-Salameh from the Division of Endocrinology, Diabetes Mellitus and Vitamin, Amiens College Hospital, Amiens, France, have printed findings of their examine titled, “The affiliation between physique mass index class and coronavirus illness 2019 outcomes,” within the newest situation of the Worldwide Journal of Weight problems.

Study: The association between body mass index class and coronavirus disease 2019 outcomes. Image Credit: Ryan R Fox / Shutterstock

Background and examine aims

Weight problems, excessive physique mass index, and diabetes have been identified to be danger elements for extreme course of COVID-19. The researchers discover from obtainable proof in scientific literature that just about 40 % of the hospitalized sufferers are overweight with a excessive BMI. Morbid weight problems, for instance, is often related to a extreme scientific course of the illness they write.

Weight problems and COVID-19 pathology

The researchers clarify that these with weight problems typically have compromised respiratory capabilities, and this predisposes them to succumb not solely SARS-CoV-2 an infection but additionally different respiratory infections.

Additional, stomach weight problems is related to a low-grade irritation, and this could alter the immune responses to infections, together with COVID-19 illness. These with weight problems are nearly at all times diabetic and should have coronary heart illness and different metabolic issues, the researchers clarify. These comorbidities make them weak to an infection with the SARS CoV-2, they add.

The primary purpose of this examine was to quantify the affiliation between physique mass index (a measure of weight problems) and significant types of COVID-19. The researchers say that that is essential to grasp to the connection between weight problems and COVID-19 with the intention to present care to weak people and forestall poor outcomes.

Research design

For this examine, the researchers included consecutive grownup sufferers with laboratory-confirmed COVID-19 who wanted to be hospitalized. They have been all admitted to the Amiens College Hospital (Amiens, France). Knowledge on the sufferers have been gathered retrospectively from the hospital database.

Confirmed COVID-19 have been these circumstances that have been confirmed on reverse-transcriptase polymerase-chain-reaction (RT-PCR) assay of nasopharyngeal swab specimens. Solely these sufferers or their authorized guardians consenting to be a part of the examine have been included within the evaluation. For the aim of this examine, normal-weight sufferers have been these with a BMI of lower than 25 kg/m2.

The essential parameters recorded have been:

  • Demographic knowledge together with age, gender, BMI, social elements
  • Danger elements
  • Medical historical past
  • Historical past of consumption of medicines of particular concern
  • Detailed scientific knowledge
  • Routine laboratory outcomes
  • Outcomes of the sufferers

The first endpoints of evaluation have been:

  • Admission into the intensive care unit (ICU) and
  • Dying

The secondary endpoints of the examine have been:

  • Want for mechanical air flow
  • Prognosis of acute respiratory misery syndrome (ARDS, based on the Berlin standards) specified on the ICU discharge observe
  • Prognosis of acute coronary syndrome (serum ranges of high-sensitivity cardiac troponin Ic above the 99th percentile for the conventional inhabitants, seen on ECG/ echocardiogram)
  • Acute renal failure (based on the Kidney Illness Bettering International Outcomes pointers)
  • Secondary an infection
  • The general period of keep within the hospital

Associations between BMI classes and the endpoints have been made utilizing logistic regression evaluation.


Total a complete of 433 sufferers hospitalized with COVID-19 have been included within the examine. An outline of the outcomes is as follows:

  • Amongst 329 sufferers whose BMI was gathered, there have been:
    • 20 (6.1 %) have been underweight
    • 95 (28.9 %) had a traditional weight
    • 90 (27.four %) have been obese
    • 124 (37.7 %) have been overweight
  • The median age for various BMI classes have been:
    • Underweight – 84.5 years
    • Regular weight – 81 years
    • Chubby – 71 years
    • Overweight – 66 years
  • ICU admission was amongst 35.1 % and 52.6 % amongst obese and overweight sufferers, respectively
  • Deaths have been seen in 23 % and 36.1 % amongst obese and overweight sufferers, respectively
  • The chances ratio of extreme illness related to the first endpoint of demise or  ICU admission based on totally different BMI classes have been as follows:
    • Chubby – Odds ratio 1.58 [0.77–3.24]
    • Overweight – Odds ratio 2.58 [1.28–5.31]
  • The chances ratio of extreme illness related to ICU admissions based on totally different BMI classes have been as follows:
    • Chubby – Odds ratio 3.16 [1.29–8.06]
    • Overweight – Odds ratio 3.05 [1.25–7.82]
  • Unadjusted ORs for deaths was identical for all BMI classes

Conclusions and implications

The group writes, “…weight problems was considerably related to a larger chance of incidence of the first endpoint (demise or ICU admission)”. The researchers wrote that being obese is extra clearly related to ICU admissions. The group concluded, “We discovered that the frequency of the first endpoint amongst sufferers with COVID-19 was twice as excessive for overweight people than for people with BMI < 25 kg/m2.” They referred to as for future bigger research in different populations to grasp the affiliation between BMI and unfavorable outcomes amongst sufferers with COVID-19.


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