Obesity, Race, and COVID-19 Mortality: Results from a Large Cohort Early in the Pandemic

HCA Healthc J Med. 2021 Aug 29;2(4):279-288. doi: 10.36518/2689-0216.1276. eCollection 2021.

Abstract

Background: Obesity has increased progressively in the United States and is a known risk factor for several diseases such as type 2 diabetes, coronary artery disease, stroke and hypertension. Amid the current pandemic, concerns have been raised about obesity as a risk factor for COVID-19 positive patients. The primary goal of this study was to explore the association between obesity and hospital mortality in COVID-19 patients. Our secondary objective was to explore the relationship between obesity and race on hospital mortality in COVID-19 patients.

Methods: This was a cross-sectional, retrospective analysis using data from 186 hospitals from across the United States and the United Kingdom during the first quarter of 2020. Extraction provided data from 25,894 patients who were tested for COVID-19, of whom 2,977 were positive. Patients were stratified into standard WHO categories for BMI and by race.

Results: Bivariate analysis revealed significant relationships between mortality and sex (p<0.001) When BMI was analyzed as a continuous variable, multivariate analysis revealed a significant influence of BMI on mortality (odds ratio=1.291, p<0.05).

Conclusion: COVID-19 mortality was significantly related to BMI, age and select co-morbidities, but race/ethnicity was not a predictor of mortality when controlling for other variables.

Keywords: COVID-19; SARS-CoV-2; body mass index; comorbidity; coronavirus infections; epidemiologic factors; obesity; pandemics; race factors; risk factors.

Grants and funding

This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity.