Overweight or obese COVID-19 patients at risk of more severe disease

COVID-19 patients who are overweight or obese have more severe symptoms and are highly likely to require invasive respiratory support, according to a new international study.

The research, led by The University of Queensland and the Murdoch Children’s Research Institute (MCRI), found obese patients had a 73 per cent greater chance of needing invasive mechanical ventilation and were more likely to require oxygen.

UQ’s Dr Kirsty Short said similar but more modest results were seen in overweight patients, but no link was found between being overweight or obese and dying in hospital from COVID-19.

“These findings have wide implications given that 40 percent of the global population is overweight or obese,” Dr Short said.

“Obesity is associated with numerous poor health outcomes, including increased risk of cardiometabolic and respiratory disease and more severe viral disease including influenza, dengue and SARS-CoV-1.

“While previous reports have indicated that obesity is an important risk factor in the severity of COVID-19, almost all of this data has been collected from single sites and many regions were not represented.

“Until now there has been limited evidence about the effects of being overweight compared to being obese on COVID-19 severity.

“These findings should serve as an important reminder about the importance of COVID-19 vaccination in anyone with excess weight.”

The study looked at hospitalised SARS-CoV-2 patients from 18 hospitals in 11 countries including China, America, Italy, South Africa and the Netherlands.

Among the 7244 patients aged 18 years and over, 34.8 per cent were overweight and 30.8 per cent were obese.

MCRI’s Dr Danielle Longmore said the findings showed the need to urgently introduce strategies to address the complex socio-economic drivers of obesity and public policy measures such as restrictions on junk food advertising.

“Although taking steps to address obesity in the short-term is unlikely to have an immediate impact in the COVID-19 pandemic, it will likely reduce the disease burden in future viral pandemics and reduce risks of complications such as heart disease and stroke,” Dr Longmore said.

MCRI Professor David Burgner, who co-led the research, said the data would help inform immunisation prioritisation for higher-risk groups.

“At the moment, the World Health Organization has not had enough high-quality data to include being overweight or obese as a risk factor for severe COVID-19 disease,” Professor Burgner said.

“Our study should help inform decisions about which higher-risk groups should be vaccinated as a priority.”

Researchers from UQ, Radboud University Medical Center in the Netherlands, University of Bern in Switzerland, the Doherty Institute, Washington University, Melbourne University, Monash University and an international BMI-COVID consortium also contributed to the study.

The research has been published in Diabetes Care (DOI: 10.2337/dc20-2676).

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