Breland 2021.

Study characteristics
Notes	English title BMI and risk for severe COVID‐19 among Veterans Health Administration patients Study setting Start of study recruitment (MM/YYYY): 03/2021 End of study recruitment (MM/YYYY): 05/2021 Study design: Prospective cohort Study centre(s): Multiple centres/clinics/areas within a country Number of centres, clinics or areas: NR Study setting: Outpatient and inpatient Number of participants recruited: 9347 Sampling method: Consecutive participants Participants Female participants (absolute number): 833 Age measure, value: NR Inclusion criteria: The Veterans Health Administration (VHA) who tested positive for COVID‐19, who had a valid BMI measurement, and who were not VHA employees. Exclusion criteria: Weight < 75 or ≥ 700 lb and height < 48 or ≥ 84 inches Smoking frequency: NR Diabetes frequency: 3560 Hypertension frequency: 5820 Cardiovascular disease frequency: 3003 Asthma frequency: 554 Chronic obstructive pulmonary disease frequency: NR Other pulmonary disease frequency: 1881 Immunosuppression frequency: 710 Chronic kidney disease frequency: 290 Cancer frequency: NR Steroid administration frequency: NR Supplemental oxygen administration frequency: NR Other treatments (frequency): NR Prognostic factor(s) Study’s definition for obesity: NR The time when obesity has been measured: Before disease or right at presentation Main variable used for determination of obesity: BMI Threshold used for definition: NR Obesity frequency (absolute number): NR Prognostic factor(s): BMI 23‐30 kg/m2 BMI 30‐39 kg/m2 Outcome(s) Mortality ICU admission Hospitalisation Outcome (prognostic factor) BMI 23‐30 kg/m2 (mortality) Follow‐up Number of patients followed completely for the outcome: 9347 Number of obese patients followed completely for the outcome: NR Number of non‐obese patients followed completely for the outcome: NR Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 0.96 (0.93, 0.98), NR Outcome (prognostic factor) BMI 23‐30 kg/m2 (ICU admission) Follow‐up Number of patients followed completely for the outcome: 9347 Number of obese patients followed completely for the outcome: NR Number of non‐obese patients followed completely for the outcome: NR Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 0.99 (0.97, 1.02), NR Outcome (prognostic factor) BMI 23‐30 kg/m2 (hospitalisation) Follow‐up Number of patients followed completely for the outcome: 9347 Number of obese patients followed completely for the outcome: NR Number of non‐obese patients followed completely for the outcome: NR Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 0.97 (0.95, 0.99), NR Outcome (prognostic factor) BMI 30‐39 kg/m2 (mortality) Follow‐up Number of patients followed completely for the outcome: 9347 Number of obese patients followed completely for the outcome: NR Number of non‐obese patients followed completely for the outcome: NR Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.02 (1.02, 1.04), NR Outcome (prognostic factor) BMI 30‐39 kg/m2 (ICU admission) Follow‐up Number of patients followed completely for the outcome: 9347 Number of obese patients followed completely for the outcome: NR Number of non‐obese patients followed completely for the outcome: NR Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.01 (1.00, 1.03), NR Outcome (prognostic factor) BMI 30‐39 kg/m2 (hospitalisation) Follow‐up Number of patients followed completely for the outcome: 9347 Number of obese patients followed completely for the outcome: NR Number of non‐obese patients followed completely for the outcome: NR Univariable unadjusted analysis for obesity Effect measure for obesity: NR Effect measure value (95% CI), P value: NR Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 1.02 (1.01, 1.03), NR
Item	Authors' judgement	Support for judgement
Study Participation	Yes	Appendix 3
Study Attrition Mortality	Unclear	Appendix 3
Study Attrition ICU admission	Unclear	Appendix 3
Study Attrition Hospitalisation	Unclear	Appendix 3
Prognostic Factor Measurement	Unclear	Appendix 3
Outcome Measurement Mortality	Yes	Appendix 3
Outcome Measurement ICU admission	Yes	Appendix 3
Outcome Measurement Hospitalisation	Yes	Appendix 3
Confounding Bias Mortality	Yes	Appendix 3
Confounding Bias ICU admission	Yes	Appendix 3
Confounding Bias Hospitalisation	Yes	Appendix 3
Statistical Analysis Bias	Yes	Appendix 3