Abstract

Background

Globally, studies show that patients with a higher body mass index (BMI) are at increased risk for severe sequelae of SARS-CoV2 infection, increasing the need for hospitalization and mechanical ventilation, ultimately increasing the risk of mortality.  

Study Design

This study considers 18 comorbidities and mortality in 229 out of 1082 patients admitted to Northeast Alabama Regional Medical Center for SARS-CoV2 infection between May 2020 and January 2021. All statistical analyses were performed in Microsoft Excel and R Studio.

Results

Using mortality as the primary outcome among five BMI classes (<18, 18-25, 25-30, 30-35, and >35), Fisher’s exact test was significant for goodness of fit (p=0.010) but not significant for independence (p=0.92). Ventilation requirements increased with BMI (p=0.0070), but did not increase mortality across weight classes (p=0.30). Cox proportional hazards adjusted for Age and CKD stage captured 34/41 total deaths and yielded a significant model (p=0.0030, 6df, concordance 0.702). For the same length of stay, every additional year of age corresponds to a 2% increase in mortality (HR 1.019, 95% CI [1.008, 1.029], p=0.00050).

Conclusions

In our sample of community hospital patients, BMI is not a significant predictor of mortality, although higher BMI is associated with increased need for mechanical ventilation. Age is a significant predictor of mortality, which has been well established. Limitations include small sample size (n=226 with 41 deaths) and inconsistent documentation of covariables in the medical records. Ongoing data collection may elucidate potential deviation from the globally reported association between obesity and SARS-CoV2 mortality.