Body mass index changes and their association with SARS-CoV-2 infection: a real-world analysis

Jithin Sam Varghese; Yi Guo; Mohammed K Ali; W Troy Donahoo; Rosette J Chakkalakal

doi:10.1101/2024.02.12.24302697

Body mass index changes and their association with SARS-CoV-2 infection: a real-world analysis

medRxiv [Preprint]. 2024 Feb 13:2024.02.12.24302697. doi: 10.1101/2024.02.12.24302697.

Authors

Jithin Sam Varghese^{1

2}, Yi Guo³, Mohammed K Ali^{1

2

4}, W Troy Donahoo⁵, Rosette J Chakkalakal^{1

2

6}

Affiliations

¹ Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, USA.
² Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA.
³ Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA.
⁴ Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, USA.
⁵ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine University of Florida Gainesville FL USA.
⁶ Department of Medicine, School of Medicine, Emory University, Atlanta, USA.

Abstract

Objective: To study body mass index (BMI) changes among individuals aged 18-99 years with and without SARS-CoV-2 infection.

Subjects/methods: Using real-world data from the OneFlorida+ Clinical Research Network of the National Patient-Centered Clinical Research Network, we compared changes over time in BMI in an Exposed cohort (positive SARS-CoV-2 test between March 2020 - January 2022), to a contemporary Unexposed cohort (negative SARS-CoV-2 tests), and an age/sex-matched Historical control cohort (March 2018 - January 2020). Body mass index (kg/m²) was retrieved from objective measures of height and weight in electronic health records. We used target trial approaches to estimate BMI at baseline and change per 100 days of follow-up for Unexposed and Historical cohorts relative to the Exposed cohort by categories of sex, race-ethnicity, age, and hospitalization status.

Results: The study sample consisted of 44,436 (Exposed cohort), 164,118 (Unexposed cohort), and 41,189 (Historical cohort). Cumulatively, 62% were women, 21.5% Non-Hispanic Black, 21.4% Hispanic and 5.6% Non-Hispanic Other. Patients had an average age of 51.9 years (SD: 18.9). At baseline, relative to the Exposed cohort (mean BMI: 29.3 kg/m² [95%CI: 29.0, 29.7]), the Unexposed (-0.07 kg/m² [95%CI; -0.12, -0.01]) and Historical controls (-0.27 kg/m² [95%CI; -0.34, -0.20]) had lower BMI. Relative to no change in the Exposed over 100 days (0.00 kg/m² [95%CI; -0.03,0.03]), the BMI of those Unexposed decreased (-0.04 kg/m² [95%CI; -0.06, -0.01]) while the Historical cohort's BMI increased (+0.03 kg/m² [95%CI;0.00,0.06]). BMI changes were consistent between Exposed and Unexposed cohorts for most population groups, except at start of follow-up period among Males and those 65 years or older, and in changes over 100 days among Males and Hispanics.

Conclusions: In a diverse real-world cohort of adults, mean BMI of those with and without SARS-CoV2 infection varied in their trajectories. The mechanisms and implications of weight retention following SARS-CoV-2 infection remain unclear.

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Abstract

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