The Journal of Clinical Endocrinology and Metabolism Journal Article

Body Mass Index and Risk of COVID-19 Outcomes

December 07, 2021
 

Martina Recalde, Andrea Pistillo, Sergio Fernandez-Bertolin, Elena Roel, Maria Aragon, Heinz Freisling, Daniel Prieto-Alhambra, Edward Burn, Talita Duarte-Salles
The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 12, December 2021, Pages e5030–e5042
https://doi.org/10.1210/clinem/dgab546

Abstract

Context

A comprehensive understanding of the association between body mass index (BMI) and coronavirus disease 2019 (COVID-19) is still lacking.

Objective

To investigate associations between BMI and risk of COVID-19 diagnosis, hospitalization with COVID-19, and death after a COVID-19 diagnosis or hospitalization (subsequent death), accounting for potential effect modification by age and sex.

Design

Population-based cohort study.

Setting

Primary care records covering >80% of the Catalan population, linked to regionwide testing, hospital, and mortality records from March to May 2020.

Participants

Adults (≥18 years) with at least 1 measurement of weight and height.

Main outcome measures

Hazard ratios (HR) for each outcome.

Results

We included 2,524,926 participants. After 67 days of follow-up, 57,443 individuals were diagnosed with COVID-19, 10,862 were hospitalized with COVID-19, and 2,467 had a subsequent death. BMI was positively associated with being diagnosed and hospitalized with COVID-19. Compared to a BMI of 22 kg/m2, the HR (95% CI) of a BMI of 31 kg/m2 was 1.22 (1.19–1.24) for diagnosis and 1.88 (1.75–2.03) and 2.01 (1.86–2.18) for hospitalization without and with a prior outpatient diagnosis, respectively. The association between BMI and subsequent death was J-shaped, with a modestly higher risk of death among individuals with BMIs ≤ 19 kg/m2 and a more pronounced increasing risk for BMIs ≥ 40 kg/m2. The increase in risk for COVID-19 outcomes was particularly pronounced among younger patients.

Conclusions

There is a monotonic association between BMI and COVID-19 diagnosis and hospitalization risks but a J-shaped relationship with mortality. More research is needed to unravel the mechanisms underlying these relationships.

Read the article

 

You may also like...

Publishing Benefits

Author Resource Center

We provide our journal authors with a variety of resources for increasing the discoverability and citation of their published work. Use these tools and tips to broaden the impact of your article.
Publishing Benefits

Author Resource Center

We provide our journal authors with a variety of resources for increasing the discoverability and citation of their published work. Use these tools and tips to broaden the impact of your article.

Thematic Issue

Latest Thematic Issue

immuno-endocrinology
Read our special collections of Endocrine Society journal articles, curated by topic, Altmetric Attention Scores, and Featured Article designations.

Read our special collections of Endocrine Society journal articles, curated by topic, Altmetric Attention Scores, and Featured Article designations.

Back to top

Who We Are

For 100 years, the Endocrine Society has been at the forefront of hormone science and public health. Read about our history and how we continue to serve the endocrine community.