SHM Converge Scientific Abstract ePoster Gallery-Association Between Obesity and Length of Covid-19 Hospitalization: Unexpected Insights From the American Heart Association National Covid-19 Registry

Association Between Obesity and Length of Covid-19 Hospitalization: Unexpected Insights From the American Heart Association National Covid-19 Registry

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This study examined whether obesity affects hospital length of stay (LOS) among adults hospitalized with COVID-19, using data from the American Heart Association National COVID-19 Registry. The authors focused on 22,915 patients initially admitted to non-intensive care and 5,327 patients initially admitted to intensive care across more than 130 U.S. hospitals.<br /><br />The rationale was that obesity is known to worsen COVID-19 outcomes, but it was unclear whether this is due mainly to respiratory compromise or also to other inflammatory and thrombotic effects. To explore this, the investigators used multivariable Poisson regression models adjusting for many patient, hospital, and physician-level factors, including respiratory status, comorbidities, and laboratory values.<br /><br />Among patients initially admitted to non-ICU care, higher BMI was associated with a statistically significant, dose-dependent decrease in LOS. Compared with normal weight patients, overweight and all obesity classes had shorter stays by about 0.32 to 0.58 days. Underweight patients did not differ significantly. In contrast, among patients initially admitted to ICU care, BMI was not significantly associated with LOS.<br /><br />The findings suggest a counterintuitive inverse relationship between BMI and LOS in less critically ill COVID-19 patients. The authors interpret this as support for an “obesity paradox” in non-critical illness, where greater metabolic reserve may help some patients recover sooner once respiratory compromise is controlled. They also suggest that obesity’s main impact on COVID-19 severity may be through reduced ventilatory reserve, which increases the risk of hospitalization and ICU need, rather than prolonging hospitalization once admitted to non-ICU care.<br /><br />Overall, the study found that obesity did not lengthen hospital stay in non-critical COVID-19; instead, higher BMI was linked to slightly shorter LOS in that group, while no LOS effect was seen in ICU patients.

Asset Subtitle

Nidhi Rohatgi

Meta Tag

Author List Alex Dahlen, Andrew Y. Chang, Connor G. O'Brien, Fatima Rodriguez, Jason Hom, Neera Ahuja, Nidhi Rohatgi, William J. Collins, Yingjie Weng

Category Research

Concept Obesity

Concept Body Mass Index

Concept COVID-19

Concept Length of Stay

Concept BMI Category

Distinguished Finalist

Presenter Organization Stanford University School of Medicine

Presenting Author Nidhi Rohatgi

Track Outcomes Research

Keywords

obesity

COVID-19

hospital length of stay

BMI

intensive care unit

non-ICU

obesity paradox

American Heart Association Registry

multivariable Poisson regression

hospitalization outcomes

Obesity

Body Mass Index

COVID-19

Length of Stay

BMI Category