Body mass index as a predictor of the severity of coronavirus infection in patients with cardiovascular pathology

Aim. To investigate the association between body mass index (BMI) and the severity of COVID-19, respiratory failure, and fatal outcome in patients with cardiovascular disease.Materials and Methods. The study included 283 patients with confirmed COVID-19. COVID-19 severity was determined according to the Russian National Guidelines for the Prevention, Diagnostics, and Treatment of COVID-19. The degree of respiratory failure was defined according to the oxygen saturation. BMI was determined by the Quetelet's index, whereas overweight and obesity were diagnosed in accordance with the World Health Organization classification.Results. Comparison of BMI in patients with mild, moderate, and severe COVID-19 did not show statistically signifi differences, although patients with overweight and obesity had a higher frequency of respiratory failure. Further, grade 3 (severe) respiratory failure had average BMI of 28.7 kg/m2 (men) and 34.2 kg/m2 (women), while those with grade 1 (mild) respiratory failure had average BMI of 26.1 kg/m2 (men) and 31.2 kg/m2 (women). In keeping with these fi  patients with a fatal outcome had higher BMI than those with a favorable outcome (31.1 kg/m2 and 27.2 kg/m2, respectively). After an adjustment for the chronic heart failure, BMI between the patients with a fatal and favourable outcome remained different (28.4 kg/m2 and 26.3 kg/m2, respectively). Logistic regression analysis showed that BMI itself had low prognostic signifi yet is became higher if combined with a COVID-19 severity and degree of respiratory failure.Conclusion. Patients with a high BMI are more likely to have a severe respiratory failure and fatal outcome. Therefore, this parameter can be used as an additional factor for the risk stratification.