Individuals in this diverse and generalizable population hospitalized with COVID-19 were more likely to be obese relative to contemporary U.S. adults. Furthermore, after statistical adjustment for age and comorbid medical conditions, obese individuals were at higher risk for the composite of in-hospital death or mechanical ventilation, death, and renal replacement therapy, but not major adverse cardiovascular events compared to normal-weight individuals. Further analysis in individuals with a BMI ≥ 40 revealed a significantly greater risk of death or mechanical ventilation in those age ≤ 50, and a moderately increased risk in those age 51-70, but no significant increase in risk for those age > 70.
Overall, obese individuals were at higher risk for death or mechanical ventilation if hospitalized with COVID-19, an important finding particularly for young adults who may otherwise believe they are at low risk for severe COVID-19. These observations warrant clear public health messaging and rigorous adherence to COVID-19 prevention strategies in obese individuals of all ages. Additionally, severely obese individuals (BMI ≥ 40 kg/m2) should be considered high risk for severe COVID-19 infection and may warrant prioritization for a COVID-19 vaccine.