Body Mass Index, Multi-Morbidity, and COVID-19 Risk Factors as Predictors of Severe COVID-19 Outcomes

Sanjeev Nanda, Audry S. Chacin Suarez, Loren Toussaint, Ann Vincent, Karen M. Fischer, Ryan Hurt, Darrell R. Schroeder, Jose R. Medina Inojosa, John C. O’Horo, Ramona S. DeJesus, Haitham S. Abu Lebdeh, Manpreet S. Mundi, Salma Iftikhar, Ivana T. Croghan

Research output: Contribution to journalArticlepeer-review


Purpose: The purpose of the present study was to investigate body mass index, multi-morbidity, and COVID-19 Risk Score as predictors of severe COVID-19 outcomes. Patients: Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between January 1, 2020 and May 23, 2020; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens. Measures: Demographic and clinical data were extracted from the electronic medical record. The data included: date of birth, gender, ethnicity, race, marital status, medications (active COVID-19 agents), weight and height (from which the Body Mass Index (BMI) was calculated, history of smoking, and comorbid conditions to calculate the Charlson Comorbidity Index (CCI) and the U.S Department of Health and Human Services (DHHS) multi-morbidity score. An additional COVID-19 Risk Score was also included. Outcomes included hospital admission, ICU admission, and death. Results: Cox proportional hazards models were used to determine the impact on mortality or hospital admission. Age, sex, and race (white/Latino, white/non-Latino, other, did not disclose) were adjusted for in the model. Patients with higher COVID-19 Risk Scores had a significantly higher likelihood of being at least admitted to the hospital (HR = 1.80; 95% CI = 1.30, 2.50; P <.001), or experiencing death or inpatient admission (includes ICU admissions) (HR = 1.20; 95% CI = 1.02, 1.42; P =.028). Age was the only statistically significant demographic predictor, but obesity was not a significant predictor of any of the outcomes. Conclusion: Age and COVID-19 Risk Scores were significant predictors of severe COVID-19 outcomes. Further work should examine the properties of the COVID-19 Risk Factors Scale.

Original languageEnglish (US)
JournalJournal of Primary Care and Community Health
StatePublished - 2021


  • BMI
  • COVID-19
  • Risk Score
  • comorbidity
  • obesity
  • pandemic

ASJC Scopus subject areas

  • Community and Home Care
  • Public Health, Environmental and Occupational Health


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