In-hospital outcomes in COVID-19 patients with non-alcoholic fatty liver disease by severity of obesity: Insights from national inpatient sample 2020

Table 1 Baseline characteristics of coronavirus disease 2019 hospitalizations in non-alcoholic fatty liver disease patients with different levels of obesity: Insights from national inpatient sample 2020

Variables		Overweight, %	Class I, %	Class II, %	Class III, %	P value
Age (yr) at admission	Mean	58	53	52	48	< 0.001
Sex	Male	58.5	59.7	52	43.3	< 0.001
	Female	41.5	40.3	48	56.7	< 0.001
Race	White	42.1	41.6	45	49.5	< 0.001
	Black	7.9	11.8	14.9	15.8	< 0.001
	Hispanic	43.8	41.4	36.3	30.9	< 0.001
	Asian/PI	5.1	4.5	1.8	2.2	< 0.001
	Nat. American	< 0.1	0.8	2	1.6	< 0.001
Payer	Medicare	34.1	26.4	26.6	19.9	< 0.001
	Medicaid	26.7	21.8	15.1	20.7	< 0.001
	Private	33	44.8	49.1	50.9	< 0.001
	Self-pay	5.1	6.7	8.7	8.1	< 0.001
Admission type	Non-elective	99	98.8	98.4	97.7	< 0.001
Comorbidities	Hypertension	61.1	56.4	58.4	59.1	0.024
	Diabetes	46.6	46.7	48.8	50.6	< 0.001
	Hyperlipidemia	45.1	42.5	41.6	32.3	< 0.001
	PVD	3.1	3.6	5.3	2.2	< 0.001
	Tobacco use disorder	19.2	21.6	20.3	17.6	< 0.001
	Prior MI	3.1	2	1.6	1.6	0.007
	Prior TIA/Stroke	3.1	2.8	3	1.7	< 0.001
	Prior VTE	2.6	4	3.6	4.2	0.090
	Cancer	5.2	2.5	1.7	2.5	< 0.001
	CKD	11.4	9.1	9.9	8.7	0.029
	Drug abuse	2.1	1.2	1.7	1.8	0.161
	Cannabis use disorder	< 0.1	0.8	0.6	0.9	0.029
	Depression	7.3	10.1	11.4	13.1	< 0.001
	Chronic pulmonary disease	15.5	18.3	21.4	26.1	< 0.001
	Hypothyroidism	10.9	9.1	10.5	13.9	< 0.001
	Bariatric surgery	< 0.1	0.9	1.9	1.5	< 0.001
Discharge	Routine	66.7	77.4	78.9	77.3	< 0.001
	Transfer to short term	< 0.1	3	2	2	< 0.001
	Hospital
	Other: SNF, ICF, etc.	16.7	6.9	7.5	9%	< 0.001
	Home health care	15.5	12.7	11.6	11.7	< 0.001
Length of stay (d)	Median	10	8	8	8	< 0.001

Overweight BMI 25-29.9; Class I Obesity BMI 30-34.9; Class II Obesity BMI 35-39.9; Class III Obesity BMI 40 or higher. PI: Pacific Islander, MI: Myocardial Infarction; PVD: Peripheral vascular disease; VTE: Venous thromboembolism; SNF: Skilled nursing facility; ICF: Intermediate care facility; MACCE: Major adverse cardiovascular and cerebrovascular events.

Table 2 Multivariable odds of in-hospital outcomes in obese coronavirus disease 2019 hospitalizations with non-alcoholic fatty liver disease

	Obesity II vs I	Obesity III vs I	Obesity I vs overweight
Outcomes	aOR [LL-UL]	aOR [LL-UL]	aOR [LL-UL]	P value
MACCE	1.19 [0.78-1.81]	1.82 [1.22-2.73]	1.66 [0.92-2.98]	0.016
Death during hospitalization	1.10 [0.69-1.76]	1.96 [1.23-3.11]	1.59 [0.84-3.02]	0.015
Acute myocardial infarction	1.91 [0.77-4.72]	2.32 [0.92-5.88]	1.72 [0.53-5.57]	0.346
Cardiac arrest	1.14 [0.49-2.67]	1.25 [0.56-2.80]	0.60 [0.13-2.78]	0.782
Acute ischemic stroke	0.23 [0.04-1.28]	0.36 [0.06-2.02]	5.52 [0.55-55.56]	0.130
Respiratory failure	1.27 [0.99-1.61]	1.35 [1.07-1.70]	0.97 [0.67-1.41]	0.049
Mechanical ventilation	0.90 [0.63-1.31]	1.34 [0.97-1.85]	1.01 [0.58-1.75]	0.095
	I vs overweight	II vs overweight	III vs overweight
Outcomes	aOR [LL-UL]	aOR[LL-UL]	aOR[LL-UL]	P value
MACCE	0.60 [0.34-1.08]	0.72 [0.39-1.32]	1.10 [0.62-1.95]	0.016
Death during hospitalization	0.63 [0.33-1.19]	0.69 [0.35-1.35]	1.23 [0.66-2.30]	0.015
Respiratory failure	1.04 [0.71-1.51]	1.28 [0.88-1.88]	1.40 [0.96-2.04]	0.057
Mechanical ventilation	0.99 [0.57-1.72]	0.90 [0.51-1.59]	1.33 [0.78-2.27]	0.095

Overweight BMI 25-29.9; Class I Obesity BMI 30-34.9; Class II Obesity BMI 35-39.9; Class III Obesity BMI 40 or higher. Multivariable regression models were adjusted for age at admission, sex, race, income quartile for patient’s ZIP code, type of admission, hospital location/teaching status, hypertension, diabetes, hyperlipidemia, peripheral vascular disease, tobacco use disorder, prior MI, prior TIA/Stroke, cancer, CKD and Bariatric surgery status. aOR: Adjusted odds ratio; LL: Lower limit, UL: Upper limit; MACCE: Major adverse cardiac and cerebrovascular events.