{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:16:20Z","timestamp":1747196180928,"version":"3.40.5"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["1R01DK130851"],"award-info":[{"award-number":["1R01DK130851"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Hope Warschaw Center for Integrated Research in Cancer and Lifestyle Award"},{"name":"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Eris M. Field Chair in Diabetes Research","award":["P30-DK063491"],"award-info":[{"award-number":["P30-DK063491"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>This study examines the value of risk stratification by documented diagnosis of diabetes and objectively measured height and weight (BMI) in COVID-19 severity and mortality in a large sample of patients in an urban hospital located in Southern California.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Data from a retrospective cohort study of COVID-19 patients treated at Cedars-Sinai Medical Center between March 8, 2020, and January 25, 2021, was analyzed. Sociodemographic characteristics and pre-existing conditions were extracted from electronic medical records. Univariable and multivariable logistic regression models identified associated risk factors, and a regression causal mediation analysis examined the role of diabetes in the association between obesity and illness severity. All analyses were stratified by age (&lt;65 and \u226565).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among individuals &lt;65yo, diabetes accounted for 19\u201330% of the associations between obesity and COVID-19 illness severity. Among patients \u226565yo, having a BMI &lt;18.5 was a risk factor for mortality regardless of diabetes history.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our findings have clinical implications in documenting which patients may be at elevated risk for adverse outcomes. More in-depth prospective studies are needed to capture how glycemic regulation may influence prognosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0265473","type":"journal-article","created":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T17:49:41Z","timestamp":1649353781000},"page":"e0265473","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["How useful are body mass index and history of diabetes in COVID-19 risk stratification?"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8202-182X","authenticated-orcid":true,"given":"Sarah-Jeanne","family":"Salvy","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geetanjali D.","family":"Datta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qihan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Lauzon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shehnaz K.","family":"Hussain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph E.","family":"Ebinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6364-5103","authenticated-orcid":true,"given":"Mark O.","family":"Goodarzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-3341","authenticated-orcid":true,"given":"Jane C.","family":"Figueiredo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"issue":"8","key":"pone.0265473.ref001","article-title":"Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico","volume":"105","author":"OY Bello-Chavolla","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"pone.0265473.ref002","doi-asserted-by":"crossref","first-page":"e13128","DOI":"10.1111\/obr.13128","article-title":"Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships","volume":"21","author":"BM Popkin","year":"2020","journal-title":"Obes Rev"},{"issue":"15","key":"pone.0265473.ref003","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1093\/cid\/ciaa415","article-title":"Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission","volume":"71","author":"J Lighter","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"7","key":"pone.0265473.ref004","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.2337\/dc20-0576","article-title":"Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China","volume":"43","author":"Q Cai","year":"2020","journal-title":"Diabetes Care"},{"key":"pone.0265473.ref005","article-title":"Impaired glucose metabolism in patients with diabetes, prediabetes, and obesity is associated with severe COVID-19","author":"SM Smith","year":"2020","journal-title":"J Med Virol"},{"issue":"10","key":"pone.0265473.ref006","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1002\/oby.22947","article-title":"Is BMI Higher in Younger Patients with COVID-19? 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