ASSOCIATION BETWEEN BODY MASS INDEX AND THE CLINICAL OUTCOMES OF COVID-19 CASES

Silva, Clarissa Bohrer da; Trindade, Letícia de Lima; Zuge, Samuel Spiegelberg; Ferraz, Lucimare; Kolhs, Marta; Heinz, Marina Klein

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ORIGINAL ARTICLE • Cogit. Enferm. 26 • 2021 • https://doi.org/10.5380/ce.v26i0.81396 copy

ASSOCIATION BETWEEN BODY MASS INDEX AND THE CLINICAL OUTCOMES OF COVID-19 CASES

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

to analyze the association between Body Mass Index and the clinical outcomes of confirmed COVID-19 cases

Method

an epidemiological study conducted with secondary data from 618 confirmed COVID-19 cases, notified from March to December 2020 in a municipality from western Santa Catarina, Brazil. An inferential analysis was performed between Body Mass Index and several clinical and assistance-related aspects

Results

a significant association was found between Body Mass Index and the following symptoms: dyspnea (p=0.003), decreased appetite (p=0.004), runny nose (p=0.039) and diarrhea (p=0.029). There was also an association with previous comorbidities (p=0.000) and worse saturation mean values (p=0.00). Obese individuals presented more chances of: hospitalization in a ward (p=0.027); hospitalization in an Intensive Care Unit (p=0.002); and evolution to death (p=0.00)

Conclusion

the need to implement effective educational actions for the prevention and treatment of obesity is evidenced, focusing on quality of life and mitigation of the clinical deterioration of this population in the face of pathologies such as COVID-19

DESCRIPTORS
Infections by Coronavirus; Pandemics; Obesity; Overweight; Body Mass Index

Variables		Normal BMI (n=518)	Overweight BMI (n=28)	Obesity BMI (n=72)
Variables		n(%)	n(%)	n(%)
Gender
	Male	266(51,4)	13(46,4)	42(58,3)
	Female	252(48,6)	15(53,6)	30(41,7)
Skin color (n=611)
	White	440(85,8)	26(92,9)	62(88,6)
	Brown	56(10,9)	2(7,1)	8(11,4)
	Black	13(2,5)	-	-
	Indigenous	2(0,4)	-	-
	Not reported in the medical chart	2(0,4)	-	-
Age
	0-19 years old	14(2,7)	1(3,6)	1(1,4)
	20-29 years old	98(18,9)	-	6(8,3)
	30-39 years old	120(23,2)	5(17,9)	9(12,5)
	40-49 years old	96(18,5)	4(14,3)	13(18,1)
	50-59 years old	64(12,4)	9(32,1)	21(29,2)
	60-69 years old	51(9,8)	4(14,3)	10(13,9)
	70-79 years old	31(6,0)	4(14,3)	7(9,7)
	80-89 years old	38(7,3)	1(3,6)	5(6,9)
	>90 years old	6(1,2)	-	-
Schooling
	Elementary School	147(28,4)	16(57,1)	32(44,4)
	High School		8(28,6)	21(29,1)
	Higher Education	101(19,5)	3(10,7)	8(11,1)
	Literate	46(8,9)	1(3,6)	4(5,6)
	Cannot read/write	9(1,7)	-	2(2,8)
	Not reported in the medical chart	78(15,1)	-	5(7,0)

Variables		Normal BMI (n=518)	Overweight BMI (n=28)	Obesity BMI (n=72)	p-value^* * Chi-square test	Cramer’s V2
Variables		n(%)	n(%)	n(%)	p-value^* * Chi-square test	Cramer’s V2
Dyspnea					0,003	0,137
	No	375(72,4)	20(71,4)	38(52,8)
	Yes	143(27,6)	8(28,6)	34(47,2)
Decreased appetite					0,004	0,132
	No	460(88,8)	19(67,9)	63(87,5)
	Yes	58(11,2)	9(32,1)	9(12,5)
	Fever				0,233	0,069
	No	309(59,7)	13(46,4)	38(52,8)
	Yes		15(53,6)	34(47,2)
Runny nose					0,039	0,103
	No	343(66,2)	23(82,1)	56(77,8)
	Yes		5(17,9)	16(22,2)
Diarrhea					0,029	0,107
	No	395(76,3)	25(89,3)	47(65,3)
	Yes		3(10,7)	25(34,7)

Variables	BMI			p-value
Variables	Normal (n=518) Mean±SD	Overweight (n=28) Mean±SD	Obesity (n=72) Mean±SD	p-value
Age	45,74±19,53	53,11±15,65	53,15±19,23	*0,002^ * ANOVA test**
Body temperature at 1st appointment (n=431)	36,43±0,81	36,40±1,05	36,58±0,81	0,396^∫ * ANOVA test
Saturation at 1st appointment (n=444)	96,22±4,24	95,34±4,41	92,68±13,12	0,000 ^∫ * ANOVA test
Number of previous comorbidities	0,83±1,36	2,18±1,27	2,71±1,65	0,000 ^∫ * ANOVA test
Number of the patient's in-person and/or telephone contacts with the health services	6,15±3,09	7,29±3,91	6,39±4,40	0,229^∫ * ANOVA test
Days from onset of the symptoms to seeking the first health care appointment (n=602)	3,86±4,48	3,50±3,76	4,03±3,86	0,515^∫ * ANOVA test
Days from onset of the symptoms to the test (n=599)	5,11±5,27	4,50±3,40	6,39±6,13	0,109^∫ * ANOVA test
Days from onset of the symptoms to discharge from home isolation (n=444)	18,26±6,91	21,50±10,73	19,51±7,20	0,165^∫ * ANOVA test

Variables		BMI			p-value	Cramer’s V2
Variables		Normal (n=518) n(%)	Overweight (n=28) n(%)	Obesity (n=72) n(%)	p-value	Cramer’s V2
Hospitalization in a ward					0,027	0,108
	Yes	84(16,2)	5(17,9)	21(29,2)
	No	434(83,8)	23(82,1)	51(70,8)
Hospitalization in an Intensive Care Unit					0,002	0,142
	Yes	72(13,9)	7(25,0)	21(29,2)	0,002	0,142
	No	446(86,1)	21(75,0)	51(70,8)
Death					0,000	0,209
	Yes	88(17,0)	5(17,9)	31(43,1)
	No	430(83,0)	23(82,1)	41(56,9)

Universidade Federal do Paraná Av. Prefeito Lothário Meissner, 632, Cep: 80210-170, Brasil - Paraná / Curitiba, Tel: +55 (41) 3361-3755 - Curitiba - PR - Brazil
E-mail: cogitare@ufpr.br

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[1] Corresponding author
Clarissa Bohrer da Silva Universidade do Estado de Santa Catarina – Chapecó, SC, Brasil E-mail: clarissa.bohrer@udesc.br