Associations between obesity and severity of coronavirus disease 2019 in Brazilian inpatients: A 2021 secondary data analysis

Abstract

SummaryIn the backdrop of the global obesity pandemic, recognized as a notable risk factor for coronavirus disease 2019 (COVID‐19) complications, the study aims to explore clinical and epidemiological attributes of hospitalized COVID‐19 patients throughout 2021 in Brazil. Focused on four distinct age cohorts, the investigation scrutinizes parameters such as intensive care unit (ICU) admission frequency, invasive mechanical ventilation (IMV) usage, and in‐hospital mortality among individuals with and without obesity. Using a comprehensive cross‐sectional study methodology, encompassing adult COVID‐19 cases, data sourced from the Influenza Epidemiological Surveillance Information System comprises 329 206 hospitalized patients. Of these individuals, 26.3% were affected by obesity. Analysis reveals elevated rates of ICU admissions, increased dependence on IMV, and heightened in‐hospital mortality among the individuals with obesity across all age groups (p < .001). Logistic regression, adjusting for confounding variables, underscores a progressively rising odds ratio for mortality in younger age brackets: 1.2 (95%CI 1.1–1.3) for those under 50 years, 1.1 (95%CI 1.0–1.2) for the 50–59 age group, and 1.1 (95%CI 1.0–1.2) for the 60–69 age group. Conversely, no significant mortality difference is observed for patients over 70 years (OR: 0.972, 95%CI 0.9–1.1). In summary, hospitalized COVID‐19 patients with obesity, particularly in younger age groups, exhibit elevated rates of ICU admission, IMV requirement, and in‐hospital mortality compared with the control group. Notably, the ‘obesity paradox’ is not evident among hospitalized COVID‐19 patients in 2021.