Relationship between Asian-BMI classification and radiographic severity index in hospitalized COVID-19 patients

Original Research


Introduction: Obesity is acknowledged to be a significant risk factor for mortality in patients with COVID-19. At primary healthcare center, early stratification of high-risk patients is critical in order to provide effective management. There is limited research available in Vietnam concerning the relationship between obesity as defined by Asian- standards and pulmonary damage. Our goal was to find the correlation between the obesity status index by Asian-standardized BMI and the severity of lung injury on chest radiographs patients with COVID-19 in the Vietnamese field hospital.

Methods: A total of 279 confirmed COVID-19 patients (118 males and 161 females) patients were recruited in our study. Two internal medicine physicians independently evaluated chest X-rays using the Brixia score system to assess the severity of lung disease, then agreed. The probability of Brixia scores per chest X-ray film was modeled using Poisson regression with gender and Asian-standardized BMI as predictors.

Results: The study revealed that the median age of our study was 59 years, and the mean BMI was 24.6 ± 3.4 kg/m2. The Pearson correlation between the Brixia score and the BMI was 0.25 with a p-value < 0.05. Both men and women showed that the obese group had the highest Brixia scores. There was a statistically significant difference between Brixia scores of male patients between the normal and obese groups (p-value =0.0446). Poisson regression showed that as the BMI increased, the probability of a higher Brixia score also increased.

Conclusions: According to the findings, the higher the BMI value of a patient, the higher the Brixia score for chest X-rays. This result was recorded in both genders, but more significantly in men. 

Graphical abstract