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?:abstract
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OBJECTIVE Examine the associations of BMI with testing positive for SARS-CoV-2 and risk of adverse outcomes in a cohort of Veterans Affairs enrollees. METHOD Adjusted relative risks/hazard ratios were calculated for the associations between BMI category (underweight, normal-weight, overweight, class 1 obesity, class 2 obesity, and class 3 obesity) and testing positive for SARS-CoV-2 or experiencing hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death among those testing positive. RESULTS Higher BMI categories were associated with higher risk of a positive SARS-CoV-2 test compared to the normal-weight category (class 3 obesity adjusted relative risk 1.34, 95% confidence interval [CI] 1.28-1.42). Among 25,952 SARS-CoV-2-positive patients, class 3 obesity was associated with higher risk of mechanical ventilation (adjusted hazard ratio [aHR] 1.77, 95%CI 1.35-2.32) and mortality (aHR 1.42, 95%CI 1.12-1.78) compared to normal-weight individuals. These associations were present primarily in patients <65 and were attenuated or absent in older age groups (interaction p<0.05). CONCLUSION VA enrollees with higher BMI were more likely to test positive for SARS-CoV-2 and were more likely to be mechanically ventilated or die if SARS-CoV-2-infected. Higher BMIs contributed relatively more to the risk of death in those <65 years of age as compared to other age categories.
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