Can reduction in infection and mortality rates from coronavirus be explained by an obesity survival paradox? An analysis at the US statewide level

Abstract

Coronavirus disease 2019 (COVID-19) is a declared global pandemic with multiple risk factors. Based on recent empirical studies, obesity is considered by several researchers as one of the serious risk factors for coronavirus-related complications. Yet, other scholars argue in favor of the existence of an obesity survival paradox. The objective of the current study is to analyze the potential relationships between different corona indicators and obesity on a statewide level. Since the United States is ranked as one of the OECD countries with a high level of overweight and obesity among its citizens-the majority of US states exceed the 30% benchmark of obese population-it is an especially interesting case study to explore this issue. In an attempt to estimate projected probabilities for infection by coronavirus and mortality rates as a function of obesity prevalence, the fractional logit regression is employed. Findings may support the counter-intuitive possibility of an obesity survival paradox. Consequently, ethical guidelines referring to priority in intubation and intensive care treatments should account for these complex relationships between obesity and corona. Both projected rates of infection and mortality drop with elevated prevalence of obesity. The reasons for these findings might be explained by several conditions such as elevated social distancing from more obese persons, increased metabolic reserves, more aggressive treatment, and unidentified factors that should be examined in future research.

Body mass index and severity/fatality from coronavirus disease 2019: A nationwide epidemiological study in Korea

“…However, regarding obesity, contradictory results–obesity paradox-were reported in previous studies [ 15 ]. Similarly, there was a recent study on ‘an obesity survival paradox’ that authors showed the projected rates of COVID-19 infection and mortality drop with elevated prevalence of obesity in United States [ 26 ]. However, in the current COVID-19 pandemic, the majority of studies reported obesity as a risk factor for progressing to severe COVID-19 and were associated with the need for hospitalization and admission to the critical care unite due to COVID-19 [ 7 , 17 , 27 , 28 ].…”

Nutrition, age, medical literacy and gender: The impact of ethnic origin (Arabs vs. Jewish Israelis) on obesity

“…(1) and (2). While columns (1), ( 3) and (5) give the random effect regression outcomes for the dependent variable Y 1 ¼ BMI, columns (2), ( 4) and ( 6) provide the outcomes for the dependent variable Y 2 ¼ lnðBMIÞ. This logarithmic transformation gives a percent approximation between projected BMI of Hebrew speakers (the base category) vs. that of the native Arab speakers and that of the age.…”

“…(3) and (4). While columns (1), ( 3) and (5) give the random effect regression outcomes for the dependent variable Y 1 ¼ BMI, columns (2), ( 4) and (6) provide the outcomes for the dependent variable Y 2 ¼ lnðBMIÞ. Once again, at the bottom of table, we report the results of the F-statistics that all elements of d !…”

“…With one exception [12], none of these studies (to the best of our knowledge) employed a follow-up sample at a national level. Following [4,5]; the objective of the current study is to fill some of this gap by comparing native Jewish and Arab Israelis and each group across gender and age. Based on a follow-up sample of the Israeli longitudinal survey covering 2012e2016 (the first longtitudinal survey at the national level), 1 we observe the correlation between the BMI, age and parent language (Hebrew vs. Arabic).…”

Some Questions to Our Chinese Colleagues Pioneering Research Into Coronavirus Disease 2019 (COVID-19)

“…Among the comorbidities, the terms "obesity" and "malnutrition" "as defined by the clinical staff " are registered in the case record form, but not the body mass index as an objective measure of obesity. Whether obesity influences the prognosis in COVID-19 is a still controversially assessed issue, and it is uncertain whether ethnic and socioeconomic differences might play a role for the discrepant findings (15)(16)(17).…”