The following is a summary of “Impact of body mass index on mechanical ventilation and outcomes of patients admitted to the hospital with COVID-19,” published in the June 2024 issue of Critical Care by Molina et al.

Rising evidence suggests a strong correlation between higher body mass index (BMI) and worse outcomes in patients with COVID-19.

Researchers conducted a retrospective study investigating how BMI impacts disease severity and the need for mechanical ventilation (MV) in patients with COVID-19.

They analyzed patients in hospitals in Houston, Texas (March 2020 to February 2022). The study included all the adult patients admitted with COVID-19. Patients were stratified into 5 groups based on respiratory support. Group 1 received invasive MV, Group 2 received BiPAP ventilation, Group 3 utilized a high-flow nasal cannula (HFNC) for oxygen supplementation, Group 4 was on a combination of HFNC and BiPAP, and Group 5 was managed on room air.

The result showed 985 adults with COVID-19 (median age: 55.7 years, BMI: 29.3 kg/m²(27-34.5 kg/m²)). Males comprised 56.2% (554) and females 43.8% (431). Overall survival rate was 81% (798 patients). Analyzing by weight class, survival rates were underweight (13/15, 86.7%), normal weight (143/175, 81.7%), overweight (267/338, 79%), obese class 1 (191/227, 84.1%), obese class 2 (98/124, 79%), and obese class 3 (87/107, 81.3%) (P=0.695). When evaluating the requirement for MV, 160 (16.1%) of all patients needed assistance. Among them, 3 (20%) patients were underweight, 25 (16%) normal-weight patients, 62 (39%) patients were overweight, 33 (21%) obese class 1 patients, 23 (14%) obese class 2 patients, and 14 (9%) obese class 3 patients required ventilation (χ2 (5)=2.613, P=0.759). Length of stay did not differ between weight groups (P=0.632),  underweight (6 days, IQR: 5-12), normal weight (7 days, IQR: 3-12), overweight (6.5 days, IQR: 4-12), obese class 1 (7 days, IQR: 4-12), obese class 2 (7.5 days, IQR: 4-14), and obese class 3 (7 days, IQR: 5-12).

Investigators concluded that no association was seen between BMI and worse outcomes in patients with COVID-19, including death, length of hospital stay, or needing MV.

Source: criticalcareshock.com/2024/04/7716/