FRI044 Racial Differences In Outcomes Of Hospitalizations For COVID-19 With Morbid Obesity: Insights From The National Inpatient Sample

Abstract

Disclosure: R.A. Gajjar: None. D. Ahluwalia: None. M. Kumar: None. S. Rai: None. H. Shaka: None.

Introduction: The prevalence of obesity has risen across the globe over the past two decades and has remained high in the United States. In addition, obesity has surfaced as an independent risk factor for severe COVID-19 infection. We sought to investigate the impact of racial differences on hospitalizations for COVID-19 with morbid obesity using a nationally representative sample. Methods: The National Inpatient Sample database for 2020 was queried to identify adult hospitalizations with a primary diagnosis of COVID-19 and a secondary diagnosis of morbid obesity, using International Classification of Diseases – 10 Clinical Modification (ICD-10-CM) codes. The primary outcome studied was inpatient mortality, while secondary outcomes included inpatient complications, mean length of stay (LOS), and mean total hospital charge (THC). Multivariate logistic and linear regression analyses were used to adjust for possible confounders and to analyze the outcomes. Results: A total of 130,570 hospitalizations for COVID-19 with morbid obesity were identified, of which 48% were Caucasians, 25% were African Americans, and 19% were Hispanics. Our analysis revealed that Hispanics were associated with significantly higher adjusted odds of inpatient mortality (Adjusted Odds Ratio [aOR]: 1.4, [95% CI: 1.23-1.60], p <0.001), increased mean LOS (1.25 days, [95% CI: 0.87-1.64], p <0.001), and higher mean THC ($34,554, [95% CI: 25,316-43,791], p <0.001) as compared to Caucasians; whereas African Americans had significantly lower adjusted odds of inpatient mortality (aOR: 0.85, [95% CI: 0.76-0.96], p=0.011) when compared to Caucasians. Additionally, complications such as sepsis (aOR 1.74, [95% CI: 1.50-2.03], p <0.001), acute respiratory failure (ARF) (aOR: 1.15, [95% CI: 1.05-1.25], p=0.003), need for intubation (aOR: 1.27, [95% CI: 1.22-1.43], p <0.001), mechanical ventilation (aOR: 1.26, [95% CI: 1.13-1.41], p <0.001), requirement of pressor support (aOR: 1.74, [95% CI: 1.32-2.31], p <0.001), the necessity of blood transfusion (aOR: 1.68, [95% CI: 1.40-2.02], p <0.001) were significantly higher in Hispanics when compared to Caucasians. Conclusion: In this retrospective analysis of admissions for COVID-19 with morbid obesity, we discovered that the Hispanic subpopulation had elevated odds of mortality, along with a greater length of hospital stay and increased cost of hospitalization when compared to Caucasians. Additionally, Hispanics had higher odds of inpatient complications such as sepsis, ARF, need for mechanical ventilation/intubation, vasopressors, and blood transfusions. Our study highlights the existence of racial disparities that significantly affect outcomes in admissions for COVID-19 with morbid obesity.

Presentation: Friday, June 16, 2023