OBJECTIVES

Obesity has been shown to be a major risk factor for poor health outcomes, among young adults diagnosed with COVID-19. This study uses real world data to investigate the association between obesity and adverse outcomes: acute kidney failure, hospitalization, ventilation and death, among a cohort of COVID-19 patients aged <60 years old.

METHODS

Real world data, comprised of electronic medical records, from approximately 54 million patients were analyzed using TriNetX Analytics. Amongst the population of patients aged <60 years, a COVID-19 diagnosis (anytime from January 20^th 2020 onwards) was defined using ICD-10 diagnosis codes or LOINC codes with a positive lab test result. Using the most recently recorded values and ICD-10 diagnosis codes, a BMI > 30 kg/m² was specified in the obese cohort, whereas a BMI < 29.9 kg/m² was specified in the non-obese cohort. The index event was defined as the COVID-19 diagnosis with or without a prior diagnosis of obesity within the last 5 years. The main outcomes, acute kidney failure, hospitalization, ventilation and death, were defined using CPT and ICD-10 PCS procedural codes and ICD-10 diagnosis codes, with a follow-up period of one month after the index event. Risk ratios (RR) were calculated and propensity score matching used to balance cohorts and adjust for confounders including age, sex, race and comorbidities. Propensity scores matched 1:1 using a nearest neighbor greedy matching algorithm with a caliper of 0.25 times the standard deviation.

RESULTS

Compared to non-obese patients, those who were obese had a higher risk for acute kidney failure RR (95%CI) 2.02 (1.51,2.70), hospitalization RR (95%CI) 2.63 (2.25,3.07), ventilation RR (95%CI) 2.23 (1.71,2.89) and death RR (95%CI) 3.01 (1.65,5.74).

CONCLUSIONS

Among COVID-19 patients aged <60 years old, obesity was associated with a higher risk for acute kidney failure, hospitalization, ventilation and death.