Excess weight is a major risk factor for severe disease after infection with SARS-CoV-2. However, the effect of BMI on COVID-19 hospital resource use has not been fully quantified. This study aimed to identify the association between BMI and hospital resource use for COVID-19 admissions with the intention of informing future national hospital resource allocation. In this community-based cohort study, we analysed patient-level data from 57 415 patients admitted to hospital in England with COVID-19 between April 1, 2020, and Dec 31, 2021. Patients who were aged 20–99 years, had been registered with a general practitioner (GP) surgery that contributed to the QResearch database for the whole preceding year (2019) with at least one BMI value measured before April 1, 2020, available in their GP record, and were admitted to hospital for COVID-19 were included. Outcomes of interest were duration of hospital stay, transfer to an intensive care unit (ICU), and duration of ICU stay. Costs of hospitalisation were estimated from these outcomes. Generalised linear and logit models were used to estimate associations between BMI and hospital resource use outcomes. Patients living with obesity (BMI >30·0 kg/m) had longer hospital stays relative to patients in the reference BMI group (18·5–25·0 kg/m; IRR 1·07, 95% CI 1·03–1·10); the reference group had a mean length of stay of 8·82 days (95% CI 8·62–9·01). Patients living with obesity were more likely to be admitted to ICU than the reference group (OR 2·02, 95% CI 1·86–2·19); the reference group had a mean probability of ICU admission of 5·9% (95% CI 5·5–6·3). No association was found between BMI and duration of ICU stay. The mean cost of COVID-19 hospitalisation was £19 877 (SD 17 918) in the reference BMI group. Hospital costs were estimated to be £2736 (95% CI 2224–3248) higher for patients living with obesity. Patients admitted to hospital with COVID-19 with a BMI above the healthy range had longer stays, were more likely to be admitted to ICU, and had higher health-care costs associated with hospital treatment of COVID-19 infection as a result. This information can inform national resource allocation to match hospital capacity to areas where BMI profiles indicate higher demand. National Institute for Health Research.

中文翻译：

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英国因 COVID-19 住院患者的 BMI 与医院资源使用之间的关联：一项基于社区的队列研究


体重过重是感染 SARS-CoV-2 后出现严重疾病的主要危险因素。然而，BMI 对 COVID-19 医院资源使用的影响尚未完全量化。本研究旨在确定 BMI 与 COVID-19 入院医院资源使用之间的关联，旨在为未来国家医院资源分配提供信息。在这项基于社区的队列研究中，我们分析了 2020 年 4 月 1 日至 2021 年 12 月 31 日期间在英格兰入院的 57~415 名 COVID-19 患者的患者水平数据。年龄在 20-99 岁的患者在全科医生 (GP) 诊所注册，该诊所在前一年 (2019 年) 为 QResearch 数据库做出了贡献，并且在 2020 年 4 月 1 日之前测量了至少一个 BMI 值，可在其 GP 记录中找到，并且因新冠肺炎入院 -其中包括 19 名。感兴趣的结果是住院时间、转入重症监护病房 (ICU) 的时间以及 ICU 住院时间。根据这些结果估计住院费用。广义线性和 Logit 模型用于估计 BMI 和医院资源使用结果之间的关联。肥胖患者 (BMI >30·0 kg/m) 相对于参考 BMI 组的患者 (18·5–25·0 kg/m; IRR 1·07, 95% CI 1·03–) 住院时间更长1·10);参考组的平均住院时间为 8·82 天 (95% CI 8·62–9·01)。肥胖患者比参考组更有可能住进 ICU（OR 2·02，95% CI 1·86–2·19）；参考组入住 ICU 的平均概率为 5·9% (95% CI 5·5–6·3)。未发现 BMI 与 ICU 住院时间之间存在关联。在参考 BMI 组中，COVID-19 住院的平均费用为 19 877 英镑 (SD 17 918)。 肥胖患者的住院费用估计要高出 2736 英镑（95% CI 2224-3248）。 BMI 高于健康范围的 COVID-19 入院患者住院时间更长，更有可能入住 ICU，因此与住院治疗 COVID-19 感染相关的医疗费用更高。这些信息可以为国家资源分配提供信息，使医院容量与 BMI 概况表明需求较高的地区相匹配。国家健康研究所。