LBSUN130 A Single Center Prospective Observational Cohort Study On The Association Of Asia Pacific Classification Of Body Mass Index, Waist Circumference, And Waist Hip Ratio With Covid 19 Outcomes And Severity In A Philippine Tertiary Hospital
Authors: Quiwa Khia Anne Patricia S , Lacar Hannah Angelica P , Garingalao Aries Bjorn C , Quiwa Kathryn Gayle S , Paz-Pacheco Elizabeth 
Published: November 2022

Abstract
This study aimed to determine the association between Asia-Pacific classification of body mass index, waist circumference and waist hip ratio of adults on clinical outcomes of COVID-19 moderate & severe patients. This single-centre prospective cohort involved adult patients diagnosed with COVID-19 who were admitted at a Philippine tertiary hospital from August to November 2021. A total of 221 patients were seen, and 182 patients were analyzed, further divided into 167 moderate and 15 severe COVID-19 patients. Inclusion criteria included ambulatory patients with COVID-19, patients with no oxygen therapy, with oxygen therapy through nasal prongs, and non-invasive ventilation. Exclusion criteria excluded patients unable to stand upright, pregnant patients, and patients with advanced directives. The primary and secondary outcomes of patients with moderate and severe COVID-19 infection were compared among Asia Pacific BMI groups. Primary outcomes were respiratory decompensation, septic shock, and mortality. The secondary outcomes included ARDS, ICU admission, length of hospital stay, and severity of COVID-19. Odds ratio and corresponding 95% confidence intervals from binary logistic regression were computed. The median age was 54.5 years and 54% were male. 7 in 10 were obese by Asia Pacific classification. The mean (±SD) waist circumference, hip circumference, and waist-hip ratio were 101.75 ± 14.27 cm, 102.65 ± 13. 06 cm, and 0.99 ± 0. 07, respectively. 58% were hypertensive and 52% were diabetic. Among patients with moderate and severe COVID-19, there was insufficient evidence to support significant variations in the incidences of septic shock, ICU admission, and mortality across BMI groups. Respiratory decompensation and sepsis were more frequently seen in obese patients, but pairwise comparisons were unable to reveal statistical significance. On univariable analysis, obesity and waist circumference were significantly associated with the odds of respiratory decompensation (95% CI p=0. 010 and p=0. 002). However, this association was not sustained upon adjustment for confounders. On univariable analysis, waist and hip circumferences were both significantly associated with the odds of ICU admission (95% CI, p=. 013 and p=. 034). After controlling for confounders, only hip ratio retained significant association, with odds for the outcome increased by 5% (95% CI 1-10%, p=0. 029) with every additional centimeter in hip circumference. BMI, waist circumference, hip circumference, or waist hip ratio were not significantly associated with COVID-19 mortality. Our findings show that obesity as defined by the Asia Pacific BMI classification may be an important modifiable risk factor that may guide policy makers in prioritization of populations for vaccination against COVID-19. Interventions that reduce weight and visceral adiposity may reduce the risk of severe COVID-19 outcomes.
Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.