BACKGROUND & AIMS New York is the current epicenter of Coronavirus disease 2019 (COVID-19) pandemic. The underrepresented minorities, where the prevalence of obesity is higher, appear to be affected disproportionately. Our objectives were to assess the characteristics and early outcomes of patients hospitalized with COVID-19 in the Bronx and investigate whether obesity is associated with worse outcomes independently from age, gender and other comorbidities. METHODS This retrospective study included the first 200 patients admitted to a tertiary medical center with COVID-19. The electronic medical records were reviewed at least three weeks after admission. The primary endpoint was in-hospital mortality. RESULTS 200 patients were included (female sex: 102, African American: 102). The median BMI was 30 kg/m2. The median age was 64 years. Hypertension (76%), hyperlipidemia (46.2%), and diabetes (39.5%) were the three most common comorbidities. Fever (86%), cough (76.5%), and dyspnea (68%) were the three most common symptoms. 24% died during hospitalization (BMI < 25 kg/m2: 31.6%, BMI 25-34 kg/m2: 17.2%, BMI ≥ 35 kg/m2: 34.8%, p = 0.03). Increasing age (analyzed in quartiles), male sex, BMI ≥ 35 kg/m2 (reference: BMI 25-34 kg/m2), heart failure, CAD, and CKD or ESRD were found to have a significant univariate association with mortality. The multivariate analysis demonstrated that BMI ≥ 35 kg/m2 (reference: BMI 25-34 kg/m2, OR: 3.78; 95% CI: 1.45-9.83; p = 0.006), male sex (OR: 2.74; 95% CI: 1.25-5.98; p = 0.011) and increasing age (analyzed in quartiles, OR: 1.73; 95% CI: 1.13-2.63; p = 0.011) were independently associated with higher in-hospital mortality. Similarly, age, male sex, BMI ≥ 35 kg/m2 and current or prior smoking were significant predictors for increasing oxygenation requirements in the multivariate analysis, while male sex, age and BMI ≥ 35 kg/m2 were significant predictors in the multivariate analysis for the outcome of intubation. CONCLUSIONS In this cohort of hospitalized patients with COVID-19 in a minority-predominant population, severe obesity, increasing age, and male sex were independently associated with higher in-hospital mortality and in general worse in-hospital outcomes.

中文翻译：

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在纽约州布朗克斯市的一组COVID-19患者中，严重肥胖，年龄增长和男性性别与院内转归较差和院内死亡率较高独立相关。

背景与目的纽约是目前冠状病毒病2019（COVID-19）大流行的震中。肥胖率较高的代表性不足的少数民族似乎受到的影响不成比例。我们的目标是评估在布朗克斯区接受COVID-19住院的患者的特征和早期结局，并调查肥胖是否与年龄，性别和其他合并症无关地导致更差的结局。方法这项回顾性研究包括首批入院三级医疗中心的COVID-19患者200例。入院后至少三周检查电子病历。主要终点是住院死亡率。结果共纳入200例患者（女性：102；非洲裔美国人：102）。BMI中位数为30 kg / m2。中位年龄是64岁。高血压（76％），高脂血症（46.2％）和糖尿病（39.5％）是三种最常见的合并症。发烧（86％），咳嗽（76.5％）和呼吸困难（68％）是三种最常见的症状。住院期间死亡24％（BMI <25 kg / m2：31.6％，BMI 25-34 kg / m2：17.2％，BMI≥35 kg / m2：34.8％，p = 0.03）。发现年龄增长（按四分位数分析），男性，BMI≥35 kg / m2（参考：BMI 25-34 kg / m2），心力衰竭，CAD和CKD或ESRD与死亡率有显着的单因素相关性。多变量分析表明BMI≥35 kg / m2（参考：BMI 25-34 kg / m2，OR：3.78; 95％CI：1.45-9.83; p = 0.006），男性（OR：2.74; 95％CI： 1.25-5.98； p = 0.011）和年龄增长（在四分位数中分析，OR：1.73； 95％CI：1.13-2.63； p = 0.011）与更高的院内死亡率相关。同样，年龄 在多变量分析中，男性，BMI≥35 kg / m2和当前或以前吸烟是增加氧合需求的重要预测因素，而在多变量分析中，男性，年龄和BMI≥35 kg / m2是插管结果的重要预测因素。结论在该人群中以少数族裔为主的COVID-19住院患者中，严重肥胖，年龄增长和男性性别与院内死亡率较高和总体上院内预后较差独立相关。