OBJECTIVE: Recent cohort studies have identified obesity as a risk factor for poor outcomes in COVID-19. To explore further the relationship between obesity and critical illness in COVID-19, we examined the association of body mass index (BMI, kg/m2) with baseline demographic and ICU parameters, laboratory values, and outcomes in a critically ill patient cohort. METHODS: In this retrospective study, we examined the first 277 consecutive patients admitted to Massachusetts General Hospital (MGH) intensive care units (ICUs) with laboratory-confirmed COVID-19. We measured BMI class, initial ICU laboratory values, physiologic characteristics including gas exchange and ventilatory mechanics, and ICU interventions as clinically available. Mortality, length of ICU admission, and duration of mechanical ventilation were measured. RESULTS: We found no difference in respiratory system compliance or oxygenation between patients with and without obesity. Patients without obesity had higher initial ferritin and D-dimer levels than patients with obesity. Standard ARDS management including prone ventilation was equally distributed between BMI groups. We found no difference in outcomes between BMI groups, including 30- and 60-day mortality and duration of mechanical ventilation. CONCLUSIONS: In this cohort of critically ill patients with COVID-19, obesity was not associated with meaningful differences in respiratory physiology, inflammatory profile, or clinical outcomes.
Obesity and Critical Illness in COVID-19: Respiratory Pathophysiology