Severe Obesity Increases Covid-19 Hospitalization and Death Risk, Studies Results

Over the past year, many scientific teams around the world have reported that obese people infected with the coronavirus are particularly likely to have a dangerous illness.

Now, Large-scale new researchDepicts in more detail the relationship between weight and Covid-19 results among approximately 150,000 adults in more than 200 hospitals across the United States.

The study, conducted by a team of researchers as the Centers for Disease Control and Prevention, found that obesity significantly increased the risk of hospitalization and death for people infected with the virus. And among obese people, the risk increases as the patient’s body mass index, or BMI, the ratio of body weight to height, increases. Researchers have found that patients with a BMI of 45 or higher who respond to severe obesity are 33% more likely to be hospitalized and 61% more likely to die than patients of healthy weight.

“The results of this study highlight the serious clinical public health effects of elevated body mass index, and the ongoing need for centralized management of Covid-19 disease, especially among patients affected by severe obesity. It suggests sex, “says lead author Lyudmyla Kompaniyets. Health Economist in the Department of Nutrition, Physical Activity and Obesity at the CDC

However, there are subtle differences in the relationship between weight and results. Underweight Covid-19 patients were less likely to be admitted to the intensive care unit or die, but were more likely to be admitted than healthy-weight patients.

Dr. Kompaniyets and her colleagues used a database of Covid-19 cases to identify 148,494 adults who were diagnosed with the disease in an American hospital last March-December. They calculated each patient’s BMI and looked for correlations between BMI and various serious consequences such as hospitalization, ICU admission, ventilator, and death.

They found that obesity, defined as a BMI of 30 or higher, increased the risk of both hospitalization and death. Patients with a BMI of 30 to 34.9 were only 7% more likely to be hospitalized and 8% more likely to die than healthy-weight patients, but their risk increased sharply as their BMI increased. did.

Providing evidence of this type of “dose-response” relationship makes the study particularly compelling, and Anne, director of lung and emergency medicine at the University of Vermont Medical Center, who was not involved in the study. Dr. Dixon said. “It shows that the worse the obesity, the worse the effect. And the fact that it gradually increases as the level of obesity increases is a kind of biology in the relationship between obesity and consequences. I think it will add to the validity. “

The association between obesity and poor outcome was strongest in patients younger than 65 years, but it was also true in the elderly. Previous small studies did not find a strong association between obesity in the elderly and the severity of Covid-19.

“We have shown that obesity remains an important risk factor for death in the elderly, as it may have had more power from this large sample size,” said a lung and critical care expert. Said Dr. Michaela R. Anderson. Columbia University Medical Center not involved in the study. “This is a beautifully done study with a large population.”

Dr. Kompaniyets and her colleagues also recorded a linear relationship between BMI and the likelihood of needing a ventilator. The higher the BMI, the more likely the patient will need such an intervention. It is invasive and can have serious complications.

The study also found that underweight patients with a BMI of less than 18.5 were 20% more likely to be hospitalized than healthy-weight patients. The reason is not entirely clear, but it may be due to the fact that some of these patients are malnourished or frail, or have other illnesses.

Researchers have found that the range of BMI associated with best results is close to the line between what is considered healthy and overweight, and gaining a few pounds extra weight protects people when they get an infection. Consistent with previous studies suggesting that it may be useful.

“The exact reason for the association is currently unknown,” said Dr. Alyson Goodman, a CDC pediatrician and medical epidemiologist and co-author of the study. One possibility is that having a little extra fat may provide a lot of necessary energy reserves in the course of a long illness.

The findings highlight the importance of carefully managing the care of severely obese patients and making vaccines and other precautions available to obese people.

“This only provides further evidence to recommend that people with high BMI be vaccinated as soon as possible,” said Sarah Y. Tartov, an infectious disease epidemiologist in Kaiser Permanente’s research and evaluation department. I did. ..