“Background: Previous studies have shown that a high body mass index (BMI) is a risk factor for severe COVID-19. The aim of the present study was to assess whether a high BMI affects the risk of death or prolonged length of stay (LOS) in patients with COVID-19 during intensive care in Sweden.
Methods and findings: In this observational, register-based study, we included patients with COVID-19 from the Swedish Intensive Care Registry admitted to intensive care units (ICUs) in Sweden… We found a significant association between BMI and the risk of the composite outcome death or LOS ≥14 days in survivors (OR per standard deviation [SD] increase 1.30, 95%CI 1.16–1.44, adjusted for sex, age and comorbidities), and this association remained after further adjustment for severity of illness (simplified acute physiology score; SAPS3) at ICU admission (OR 1.30 per SD, 95%CI 1.17–1.45). Individuals with a BMI ≥ 35 kg/m2 had a doubled risk of the composite outcome. A high BMI was also associated with death during intensive care and a prolonged LOS in survivors assessed as separate outcomes…
Conclusions: In this large cohort of Swedish ICU patients with COVID-19, a high BMI was associated with increasing risk of death and prolonged length of stay in the ICU…
Discussion: Previous studies, both observational and studies using the Mendelian randomization approach, have consistently found higher susceptibility and severity of the COVID-19 disease course in individuals with obesity. A UK study including almost 7 million individuals concluded increased risk of hospitalization and death due to COVID-19 in individuals with obesity… Another study that included over 17 million adults observed increased risk of COVID-19 related death with increasing obesity… Furthermore, one previous Swedish study found an increased risk of severe COVID-19 in patients with obesity with the most pronounced excess risk in individuals younger than 56 years of age… In the present study, using up-to-date BMI data, we found that a high BMI was associated with increased risk of death and prolonged intensive care in patients with severe COVID-19 after adjustment of age, sex and comorbidities...”
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