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Epidemiology - Outcomes

Research Snapshot Theater: Epidemiology - Outcomes, Adult II

(331) The Impact of Morbid Obesity on the Severity of COVID-19 Infection: 2020-2021 Nationwide Analysis

Tuesday, February 25, 2025
8:45am – 9:45am Eastern Time
Location: Connections Central - RST 02

    First Author(s)

  • Antony Arumairaj, MD

    New York City Health and Hospitals Coporation.
    New York Medical College
    New York, New York, United States

    • Co-Author(s)

  • JM

    Joseph Mattana, MD

    Department Chair
    New York Medical College, NYC Health and Hospitals/Metropolitan.
    New York, New York, United States

  • SC

    Shobhana Chaudhari, MD

    Program director
    New York Medical College, NYC Health and Hospitals/Metropolitan.
    New York, New York, United States

  • BP

    Binay Panjiyar, n/a

    Post Doctoral Fellow
    The Johns Hopkins University School of Medicine, United States

  • TN

    Thomas Newman, MD

    Attending Physician
    New York Medical College, NYC Health and Hospitals/Metropolitan.
    New York, New York, United States

Introduction: Clinical studies have shown that obesity is a risk factor for severe COVID-19 infection. However, patients with morbid obesity have been noted to have more severe COVID-19 infection with higher need for ICU admissions, higher need for invasive ventilation and higher mortality. There was no large database analysis to determine the impact of morbid obesity. This National Inpatient Sample (NIS) study aimed to determine the impact of morbid obesity on the severity of COVID-19 infection.

Methods: We identified patients hospitalized with COVID-19 infection and a history of morbid obesity from the 2020-2021 NIS database. STATA/MP 17.0 software was used for statistical analysis. Multivariate logistic regression analysis was performed.

Results: 818,011 patients were hospitalized with COVID-19 infection, and 880,548 hospitalized patients had a history of morbid obesity. The patients with COVID-19 infection were stratified based on their morbid obesity status. There were 721,062 COVID patients without morbid obesity and 96,949 COVID patients with morbid obesity. Caucasians constituted the largest ethnic group in both groups. Patients in the lowest national income quartile and those with Medicaid insurance constituted the largest group among the national income quartile and insurance groups, respectively, in both groups. The length of hospital stay among COVID patients with morbid obesity was 9.1 days; for those without morbid obesity, it was 8.1 days, with a P value of < 0.001. The unadjusted odds ratio (OR) of invasive ventilation in COVID patients with morbid obesity was 1.59, and the adjusted OR, after adjustment for age, sex, race, Charlson comorbid index, national income quartile, and insurance, was 1.70, with a P-value of < 0.001. The unadjusted OR of mortality in COVID patients with morbid obesity was 1.03, and the adjusted OR of mortality was 1.54 with a P-value of < 0.001, indicating that the mortality rate among COVID patients with morbid obesity was significantly higher than those without morbid obesity.

Conclusions: Patients with COVID-19 infection and morbid obesity had longer length of stay, higher need for invasive ventilation, and higher mortality rate than those without morbid obesity. The NIS analysis shows that morbid obesity is a major risk factor for severe COVID-19 infection.