McKenna C Eastment1, Kristin Berry2, Emily Locke2, Pamela Green2, Ann O'Hare3, Kristina Crothers4, Jason A Dominitz5, Vincent S Fan4, Javeed A Shah1, George N Ioannou5. 1. Division of Allergy and Infectious Disease, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington, USA. 2. VA Office of Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA. 3. Division of Nephrology, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington, USA. 4. Division of Pulmonary and Critical Care, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington, USA. 5. Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington, USA.
Abstract
OBJECTIVE: The purpose of this study is to examine the associations of BMI with testing positive for severe acute respiratory coronavirus 2 (SARS-CoV-2) and risk of adverse outcomes in a cohort of Veterans Affairs enrollees. METHOD: Adjusted relative risks/hazard ratios (HRs) were calculated for the associations between BMI category (underweight, normal weight, overweight, class 1 obesity, class 2 obesity, and class 3 obesity) and testing positive for SARS-CoV-2 or experiencing hospitalization, intensive care unit admission, mechanical ventilation, and death among those testing positive. RESULTS: Higher BMI categories were associated with higher risk of a positive SARS-CoV-2 test compared with the normal weight category (class 3 obesity adjusted relative risk: 1.34, 95% CI: 1.28-1.42). Among 25,952 patients who tested positive for SARS-CoV-2, class 3 obesity was associated with higher risk of mechanical ventilation (adjusted HR [aHR]: 1.77, 95% CI: 1.35-2.32) and mortality (aHR: 1.42, 95% CI: 1.12-1.78) compared with normal weight individuals. These associations were present primarily in patients younger than 65 and were attenuated or absent in older age groups (interaction P < 0.05). CONCLUSION: Veterans Affairs enrollees with higher BMI were more likely to test positive for SARS-CoV-2 and were more likely to be mechanically ventilated or die if infected with SARS-CoV-2. Higher BMI contributed relatively more to the risk of death in those younger than 65 years of age as compared with other age categories. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVE: The purpose of this study is to examine the associations of BMI with testing positive for severe acute respiratory coronavirus 2 (SARS-CoV-2) and risk of adverse outcomes in a cohort of Veterans Affairs enrollees. METHOD: Adjusted relative risks/hazard ratios (HRs) were calculated for the associations between BMI category (underweight, normal weight, overweight, class 1 obesity, class 2 obesity, and class 3 obesity) and testing positive for SARS-CoV-2 or experiencing hospitalization, intensive care unit admission, mechanical ventilation, and death among those testing positive. RESULTS: Higher BMI categories were associated with higher risk of a positive SARS-CoV-2 test compared with the normal weight category (class 3 obesity adjusted relative risk: 1.34, 95% CI: 1.28-1.42). Among 25,952 patients who tested positive for SARS-CoV-2, class 3 obesity was associated with higher risk of mechanical ventilation (adjusted HR [aHR]: 1.77, 95% CI: 1.35-2.32) and mortality (aHR: 1.42, 95% CI: 1.12-1.78) compared with normal weight individuals. These associations were present primarily in patients younger than 65 and were attenuated or absent in older age groups (interaction P < 0.05). CONCLUSION: Veterans Affairs enrollees with higher BMI were more likely to test positive for SARS-CoV-2 and were more likely to be mechanically ventilated or die if infected with SARS-CoV-2. Higher BMI contributed relatively more to the risk of death in those younger than 65 years of age as compared with other age categories. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
Authors: Michaela R Anderson; Joshua Geleris; David R Anderson; Jason Zucker; Yael R Nobel; Daniel Freedberg; Jennifer Small-Saunders; Kartik N Rajagopalan; Richard Greendyk; Sae-Rom Chae; Karthik Natarajan; David Roh; Ethan Edwin; Dympna Gallagher; Anna Podolanczuk; R Graham Barr; Anthony W Ferrante; Matthew R Baldwin Journal: Ann Intern Med Date: 2020-07-29 Impact factor: 25.391
Authors: Christopher M Petrilli; Simon A Jones; Jie Yang; Harish Rajagopalan; Luke O'Donnell; Yelena Chernyak; Katie A Tobin; Robert J Cerfolio; Fritz Francois; Leora I Horwitz Journal: BMJ Date: 2020-05-22
Authors: Eyal Klang; Gassan Kassim; Shelly Soffer; Robert Freeman; Matthew A Levin; David L Reich Journal: Obesity (Silver Spring) Date: 2020-08-02 Impact factor: 9.298
Authors: Elizabeth J Williamson; Alex J Walker; Krishnan Bhaskaran; Seb Bacon; Chris Bates; Caroline E Morton; Helen J Curtis; Amir Mehrkar; David Evans; Peter Inglesby; Jonathan Cockburn; Helen I McDonald; Brian MacKenna; Laurie Tomlinson; Ian J Douglas; Christopher T Rentsch; Rohini Mathur; Angel Y S Wong; Richard Grieve; David Harrison; Harriet Forbes; Anna Schultze; Richard Croker; John Parry; Frank Hester; Sam Harper; Rafael Perera; Stephen J W Evans; Liam Smeeth; Ben Goldacre Journal: Nature Date: 2020-07-08 Impact factor: 49.962
Authors: Sara Y Tartof; Lei Qian; Vennis Hong; Rong Wei; Ron F Nadjafi; Heidi Fischer; Zhuoxin Li; Sally F Shaw; Susan L Caparosa; Claudia L Nau; Tanmai Saxena; Gunter K Rieg; Bradley K Ackerson; Adam L Sharp; Jacek Skarbinski; Tej K Naik; Sameer B Murali Journal: Ann Intern Med Date: 2020-08-12 Impact factor: 25.391
Authors: Christopher T Rentsch; Farah Kidwai-Khan; Janet P Tate; Lesley S Park; Joseph T King; Melissa Skanderson; Ronald G Hauser; Anna Schultze; Christopher I Jarvis; Mark Holodniy; Vincent Lo Re; Kathleen M Akgün; Kristina Crothers; Tamar H Taddei; Matthew S Freiberg; Amy C Justice Journal: PLoS Med Date: 2020-09-22 Impact factor: 11.069
Authors: George N Ioannou; Jacqueline M Ferguson; Ann M O'Hare; Amy S B Bohnert; Lisa I Backus; Edward J Boyko; Thomas F Osborne; Matthew L Maciejewski; C Barrett Bowling; Denise M Hynes; Theodore J Iwashyna; Melody Saysana; Pamela Green; Kristin Berry Journal: PLoS Med Date: 2021-10-21 Impact factor: 11.613
Authors: Annukka A R Antar; Tong Yu; Nora Pisanic; Razvan Azamfirei; Jeffrey A Tornheim; Diane M Brown; Kate Kruczynski; Justin P Hardick; Thelio Sewell; Minyoung Jang; Taylor Church; Samantha N Walch; Carolyn Reuland; Vismaya S Bachu; Kirsten Littlefield; Han-Sol Park; Rebecca L Ursin; Abhinaya Ganesan; Oyinkansola Kusemiju; Brittany Barnaba; Curtisha Charles; Michelle Prizzi; Jaylynn R Johnstone; Christine Payton; Weiwei Dai; Joelle Fuchs; Guido Massaccesi; Derek T Armstrong; Jennifer L Townsend; Sara C Keller; Zoe O Demko; Chen Hu; Mei-Cheng Wang; Lauren M Sauer; Heba H Mostafa; Jeanne C Keruly; Shruti H Mehta; Sabra L Klein; Andrea L Cox; Andrew Pekosz; Christopher D Heaney; David L Thomas; Paul W Blair; Yukari C Manabe Journal: Open Forum Infect Dis Date: 2021-04-16 Impact factor: 3.835