Palaiodimos 2020.

Study characteristics
Notes	English title Severe obesity, increasing age and male sex are independently associated with worse in‐hospital outcomes, and higher in‐hospital mortality, in a cohort of patients with COVID‐19 in the Bronx, New York Study setting Start of study recruitment (MM/YYYY): 03/2020 End of study recruitment (MM/YYYY): 03/2020 Study design: Retrospective cohort Study centre(s): Single centre/clinic/area within a country Number of centres, clinics or areas: 1 Study setting: Inpatient Number of participants recruited: 200 Sampling method: Consecutive participants Participants Female participants (absolute number): 102 Age measure, value: Median (IQR), 64 (50‐73.5) Inclusion criteria: The first patients who presented to the emergency room (ER) and were admitted to the inpatient medicine service or the intensive care unit (ICU) with laboratory‐confirmed COVID‐19 Exclusion criteria: 1. Discharge home directly from the ER, 2. Transfer to the centre after having received care in other institutions, 3. Admission for non‐COVID‐19 related reasons or non‐medical reasons (e.g. patients admitted because of a fracture, clinically stable patients residing in group homes unable to self‐isolate) Smoking frequency: 65 Diabetes frequency: 79 Hypertension frequency: 152 Cardiovascular disease frequency: 34 Asthma frequency: 27 Chronic obstructive pulmonary disease frequency: 28 Other pulmonary disease frequency: NR Immunosuppression frequency: 5 Chronic kidney disease frequency: 58 Cancer frequency: 11 Steroid administration frequency: NR Supplemental oxygen administration frequency: NR Other treatments (frequency): 17 (immunosuppressive therapy) Prognostic factor(s) Study’s definition for obesity: Three groups based on the BMI: BMI < 25 kg/m2, BMI 25–34 kg/m2, and BMI ≥ 35 kg/m2 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: 25 Obesity frequency (absolute number): 162 Prognostic factor(s): ΒΜI ≥ 35 Outcome(s) Mortality Mechanical ventilation Outcome (prognostic factor) Mortality (ΒΜI ≥ 35) (model 1) Follow‐up Number of patients followed completely for the outcome: 200 Number of obese patients followed completely for the outcome: 162 Number of non‐obese patients followed completely for the outcome: 38 Univariable unadjusted analysis for obesity Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 2.56 (1.18, 5.57), 0.018 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: 3.35 (1.43, 7.87), 0.005 Outcome (prognostic factor) Mortality (ΒΜI ≥ 35) (model 2) Follow‐up Number of patients followed completely for the outcome: 200 Number of obese patients followed completely for the outcome: 162 Number of non‐obese patients followed completely for the outcome: 38 Univariable unadjusted analysis for obesity Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 2.56 (1.18, 5.57), 0.018 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age, sex, heart failure, coronary artery disease, CKD or ESRD, COPD Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 3.94 (1.56, 9.92), 0.004 Outcome (prognostic factor) Mortality (ΒΜI ≥ 35) (model 3) Follow‐up Number of patients followed completely for the outcome: 200 Number of obese patients followed completely for the outcome: 162 Number of non‐obese patients followed completely for the outcome: 38 Univariable unadjusted analysis for obesity Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 2.56 (1.18, 5.57), 0.018 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age, sex, heart failure, coronary artery disease, CKD or ESRD, COPD, diabetes, current or former smoker Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 3.78 (1.45, 9.83), 0.006 Outcome (prognostic factor) Mechanical ventilation (ΒΜI ≥ 35) (model 1) Follow‐up Number of patients followed completely for the outcome: 200 Number of obese patients followed completely for the outcome: 162 Number of non‐obese patients followed completely for the outcome: 38 Univariable unadjusted analysis for obesity Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 2.72 (1.24, 5.96), 0.012 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: 3.19 (1.42, 7.17), 0.005 Outcome (prognostic factor) Mechanical ventilation (ΒΜI ≥ 35) (model 2) Follow‐up Number of patients followed completely for the outcome: 200 Number of obese patients followed completely for the outcome: 162 Number of non‐obese patients followed completely for the outcome: 38 Univariable unadjusted analysis for obesity Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 2.72 (1.24, 5.96), 0.012 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age, sex, heart failure, coronary artery disease, CKD or ESRD, COPD Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 4.06 (1.72, 9.57), 0.001 Outcome (prognostic factor) Mechanical ventilation (ΒΜI ≥ 35) (model 3) Follow‐up Number of patients followed completely for the outcome: 200 Number of obese patients followed completely for the outcome: 162 Number of non‐obese patients followed completely for the outcome: 38 Univariable unadjusted analysis for obesity Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 2.72 (1.24, 5.96), 0.012 Multivariable analysis for obesity Modelling method: Logistic regression The set of prognostic factors used for adjustment: Age, sex, heart failure, coronary artery disease, CKD or ESRD, COPD, diabetes, current or former smoker Effect measure for obesity: Odds ratio Effect measure value (95% CI), P value: 3.87 (1.47, 10.18), 0.006
Item	Authors' judgement	Support for judgement
Study Participation	Yes	Appendix 3
Study Attrition Mortality	Yes	Appendix 3
Study Attrition Mechanical ventilation	Yes	Appendix 3
Prognostic Factor Measurement	Yes	Appendix 3
Outcome Measurement Mortality	Yes	Appendix 3
Outcome Measurement Mechanical ventilation	Yes	Appendix 3
Confounding Bias Mortality	Yes	Appendix 3
Confounding Bias Mechanical ventilation	Unclear	Appendix 3
Statistical Analysis Bias	Yes	Appendix 3