Health
Elevated BMI also associated with other severe respiratory infections
A study using data from the UK Biobank found that the higher your body mass index (BMI), the higher your risk of hospitalization and death from COVID-19 and other respiratory infections.
After a mean of 11.8 years of follow-up, the hazard ratios for each 10 units higher BMI were 2.26 (95% CI 2.05-2.49) for severe COVID-19 and 1.74 (95% CI 1.68- 1.80). (LRTI) and severe upper respiratory tract infection (URTI) in a fully adjusted model accounting for age, sex, race, and many other factors of 1.37 (95% CI 1.24-1.51) (P.<0.001 trend).
“This study supports previous findings that a 10-unit increase in BMI approximately doubles the risk of severe COVID-19.” jam. “In contrast, the limited evidence to date for an association between BMI and the risk of severe LRTI or URTI indicates considerable variability in the strength of these associations.”
For all three infections, people with a BMI between 35 and 60 had the highest risk of severe disease.
- COVID: HR 2.38 (95% CI 2.07-2.74)
- LRTIs: HR 1.91 (95% CI 1.83-2.00)
- URTI: HR 1.40 (95% CI 1.20-1.64)
“Although some studies have described a higher BMI to be associated with a lower risk of LRTI, the current study found no such evidence in the BMI categories investigated.” This suggests that the mechanisms proposed between LRTI and COVID-19 (including obesity-related chronic disease or decreased respiratory function) may be shared with other LRTIs.”
The authors used BMI and severe COVID-19, as well as other diseases such as influenza. a 2018 survey It was also shown that obesity was associated with more frequent upper and lower respiratory tract infections when compared to ‘normal weight’.
In addition to being a risk factor for these infections, Obesity is also associated with respiratory symptoms. Orthopnea, dyspnea, wheezing, etc.
“The findings support individual and population-level approaches to reduce obesity and targeted vaccination programs against respiratory infections in individuals with high BMI,” Bohrmann and colleagues concluded. I was.
In this study, the authors used data from a prospective UK Biobank cohort. They excluded participants with prevalent chronic respiratory disease, previous hospitalization for infectious respiratory disease, and missing or extreme values for key variables.
A total of 476,176 participants were included. The median age he was 58 years old was 54% female and 94% white. The average BMI was 27.4.
Hazard ratios were adjusted for age at risk, sex, region, race, Townsend deprivation score, education, smoking, and alcohol consumption.
Of the 20,302 participants who were hospitalized or died, 1,296 were COVID (144 died without hospitalization), 17,085 were LRTI (273 died without hospitalization), 1,504 were URTI (death without hospitalization). person) was
The crude incidence of severe COVID ranged from 1.2 per 1,000 person-years in persons with a BMI <25 to 5.8 per 1,000 person-years in persons with a BMI of 35–60. The incidence of severe LRTI ranged from 25.6 to 55.50 per 1,000 person-years across BMI groups. The incidence of severe URTI ranged from 2.2 per 1,000 person-years in persons with a BMI <25 to 4.4 per 1,000 person-years in persons with a BMI of 35–60.
Bohrmann and team noted that associations could not be analyzed by LRTI subtype, a limitation of their study. Furthermore, the UK Biobank is not representative of the general population and could not separate the ‘underweight’ and ‘healthy weight’ groups.
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Disclosure
This work was supported by a grant from the Medical Research Council (awarded to the University of Oxford’s Clinical Trial Services Unit) and a grant from the British Heart Foundation.
Bohrmann was supported by a PhD scholarship from the Nuffield Department of Population Health.
The co-authors reported relationships with the UK Medical Research Council, the Amgen-supported US Foundation for Disease Control and Prevention, and the World Health Organization.
Primary information
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Source reference: Bohrmann B, et al. Body Mass Index and Risk of Hospitalization or Death from Lower or Upper Respiratory Tract Infection. JAMA 2023; DOI: 10.1001/jama.2023.2619.
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