Association between obesity and hospitalization in mild COVID-19 young adult outpatients in Brazil: a prospective cohort study

Sartor, I. T. S.; David, C. N.; Telo, G. H.; Zavaglia, G. O.; Fernandes, I. R.; Kern, L. B.; Polese-Bonatto, M.; Azevedo, T. R.; Santos, A. P.; Almeida, W. A. F.; Porto, V. B. G.; Varela, F. H.; Scotta, M. C.; Rosa, R. G.; Stein, R. T.

Background/Objectives The aim of this study was to evaluate the association between obesity and hospitalization in mild COVID-19 adult outpatients in Brazil. Subjects/Methods Adults with signs and symptoms suggestive of acute SARS-CoV-2 infection who sought two hospitals (one public and one private) emergency department were prospectively enrolled. Patients with confirmed COVID-19 at inclusion were followed by phone calls at day (D) D7, D14 and D28. Multivariable logistic regression models were employed to explore the association between obesity and other potential predictors for hospitalization. Results A total of 1,050 participants were screened, 310 were diagnosed with COVID-19 by RT-PCR. Median age was 37.4 (IQR 29.8-45.0) years, and 186 (60.0%) were female. Duration of symptoms was 3.0 (IQR 2.0-5.0) days, and 10.0 (IQR 8.0-12.0) was the median number of symptoms at inclusion. A total of 98 (31.6%) were obese, and 243 (78.4%) had no previous medical conditions. Twenty three participants (23/310, 7.4%) required hospitalization during the period. After adjusting, obesity (BMI[≥]30.0 kg/m2) (OR=2.69, 95%CI 1.63-4.83, P<0.001) and older age (OR=1.05, 95%CI 1.01-1.09, P<0.001), were significantly associated with higher risks of hospitalization. Conclusions Obesity, followed by aging, was the main factor associated with hospital admission for COVID-19 in a young population in a low-middle income country. Our findings highlighted the need for actions to promote additional protection for obese population, such as vaccination, and to encourage lifestyle changes.