Obesity a significant risk factor for death from COVID-19 infection, especially in men

Researchers found a striking association between BMI and risk for death among patients with a diagnosis of COVID-19. The association was independent of obesity-related comorbities and other potential confounders. Their findings also suggest that high BMI was more strongly associated with COVID-19 mortality in younger adults and male patients, but not in female patients and older adults. A retrospective cohort study is published in Annals of Internal Medicine. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-3742.

Researchers studied health records for more than 6,900 patients treated for COVID-19 in the Kaiser Permanete Southern California health care system from February to May 2020 to determine the association between obesity and death from COVID-19. The obesity risk was adjusted for common comorbidities, including diabetes, hypertension, heart failure, myocardial infarction, and chronic lung or renal disease, which themselves are risk factors for poor outcomes in COVID-19. The study also took into account when SARS-CoV-2 was detected. They found that patients in the highest weight group were 4 times as likely to die within 21 days of being diagnosed with COVID-19 as those in the normal weight group. Men and those younger than 60 years who had a high body weight were at particularly high risk for death. According to the researchers, identifying obesity as an independent risk factor is important so that patients with obesity can take extra precautions and health care providers and public health officials can consider this when providing care and making public health decisions.

The author of an accompanying editorial from The Johns Hopkins University School of Medicine suggests that these findings in addition to prior research should put to rest any notion that obesity is common in severe COVID-19 because it is common in the population. The research proves that obesity is an important independent risk factor for serious COVID-19 disease and that the risks are higher in younger patients. According to the author, this is probably not because obesity is particularly damaging in this age group; it is more likely that other serious comorbidities that evolve later in life take over as dominant risk factors. That males are particularly affected may reflect their greater visceral adiposity over females. Read the full text: https://www.acpjournals.org/doi/10.7326/M20-5677.