BMI is Associated with Coronavirus Disease 2019 Intensive Care Unit Admission in African Americans

Alkhatib, Ala L.; Kreniske, Jonah; Zifodya, Jerry S.; Fonseca, Vivian; Tahboub, Mohammad; Khatib, Joanna; Denson, Joshua L.; Lasky, Joseph A.; Lefante, John J.; Bojanowski, Christine M.

OBJECTIVE: Coronavirus disease 2019 (COVID‐19) has disproportionately impacted the African American community. This study aims to identify the risk factors for severe COVID‐19 disease in African American patients. METHODS: This was a retrospective cross‐sectional analysis of African American patients with COVID‐19 treated between March 12 and April 9, 2020, at a single tertiary center. The primary outcome of interest was severe disease defined as those requiring intensive care unit (ICU) admission. RESULTS: The study included 158 consecutive patients. The mean age was 57 years, and 61% were women. The mean (SD) of BMI was 33.2 (8.6) kg/m(2). Overall, patients admitted to the ICU were older (62 vs. 55 years, P = 0.003) and had higher BMI (36.5 kg/m(2) vs. 31.9 kg/m(2), P = 0.002). In unadjusted and adjusted analysis, the factors most associated with ICU admission in this sample were age (adjusted odds ratio [aOR]: 1.073; 95% CI: 1.033‐1.114), BMI (aOR: 1.115; 95% CI: 1.052‐1.182), and lung disease (aOR: 3.097; 95% CI: 1.137‐8.437). CONCLUSIONS: This study identified risk factors for severe disease in COVID‐19, specifically in an African American population. Further inclusive research aimed at optimizing clinical care relevant to the African American population is critical to ensure an equitable response to COVID‐19.