High BMI a risk factor for severe COVID-19 disease

Obesity appears to be a risk factor for severe COVID-19 disease according to preliminary findings from hotspots in France where high BMI was associated with a three-fold higher risk of ICU treatment.

A retrospective analysis of BMI data for 340 patients hospitalised in Lyon for COVID-19 disease found that a BMI over 30 kg/m2 was associated with a 35% higher risk of severe COVID-19 disease and a 89% higher risk of needing ICU care for COVID-19 disease compared to the general population.

And preliminary data from 124 COVID-19 patients managed in a Lille hospital found that a BMI over 30 kg/m2 was associated with 2.89 prevalence ratio for ICU treatment compared to the general population.

Published in Lancet Diabetes and Endocrinology, the findings appeared to confirm reports from the US that suggested obesity, as defined by BMI of at least 30 kg/m2, might be a risk factor for ICU admission among patients with COVID-19, especially among those younger than 60 years, said researchers from the Université Claude Bernard, Lyon.

They report that 85 (25%) of 340 patients with severe COVID-19 in the Lyon hospital had obesity, compared with 15·3% in the French adult population. Aside form differences in obesity, they found no relevant differences in clinical features between patients with and without high BMI in the ICU.

In the Lille hospital they also found that the prevalence of obesity in patients with critical COVID-19 was higher than in ICU patients without COVID-19 (Odds Ratio) after standardisation on age and sex.

There was also a significantly higher for critical COVID-19 versus non-critical COVID-19 disease in patients with obesity than in patients without obesity with age-sex-adjusted ORs ranging between 1·80 and 2·03.

There was also a suggestion that risks of invasive mechanical intubation were even higher in male patients and those with higher BMI, especially at least 35.

The researchers said the role of obesity as a risk factor for poor prognosis in COVID-19 should be explored in larger studies with longer follow up of outcomes such as duration of hospitalisation and mortality.

“Given the dual pandemics of COVID-19 and obesity in high-income countries, our findings have major implications for the clinical care of patients with obesity and COVID-19, as well as for public health interest,” they wrote.

“These findings can help clinicians to better identify specific populations with higher risk of severe disease, which could lead to an increase in protective measures, proposal of serological screening for immunisation, and recommendation of a vaccination once available for people with obesity.”

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