Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish Nationwide Cohort Study (TurCObesity)

Abstract

Purpose While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19), factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of COVID-19 patients who were overweight or obese and variables associated with severe disease in a large group of consecutive cases. Methods A nationwide retrospective cohort study was performed using the Turkish National Healthcare Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients registered between March 11 and May 30, 2020, were recorded. Results A total of 14, 625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight (34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission, intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04–3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02–1.05; p<0.001) were associated with a higher intubation/mechanical ventilation rate but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40–4.67; p=0.002). Old age, male gender, chronic kidney disease, and high C reactive protein levels were independently associated with COVID-19 mortality in overweight or obese patients. Conclusions COVID-19 patients who were overweight or obese were more likely to have adverse outcomes but only obesity was a predictor of mortality. Such patients should receive urgent medical attention and active management, especially the elderly, men, and people with chronic kidney disease.

Acceptance of COVID-19 vaccination and influencing factors among people living with HIV in Guangxi, China: a cross-sectional survey

“…Several studies have identified the high-risk factors for severe COVID-19, including elderly, hypertension, overweight, diabetes, and cardiovascular disease [ 7 , 8 ], while an important population, people living with HIV (PLWH), is under-studied and should not be ignored. By the end of 2020, about 37.7 million people were reported to be living with HIV globally [ 9 ].…”

Influence of Nutritional Intakes in Japan and the United States on COVID-19 Infection

“…Obesity leads to chronic inflammation and lowered immunity [ 5 ]. Obesity was found to be associated with a higher intubation/mechanical ventilation rate and increased mortality in COVID-19 patients ( p = 0.002) [ 15 ]. Moreover, obesity is a known risk factor for cardiovascular diseases, hypertension, type 2 diabetes mellitus, respiratory diseases, and some types of cancer [ 5 ].…”

“…However, in a study of two genetic risk scores for obesity, based on 31 or 68 single nucleotide polymorphisms, no associations were found between the scores and changes in obesity markers, and no significant gene–diet interactions were found [ 73 ]. As mentioned previously, obesity is a major risk factor for COVID infection [ 5 , 15 , 74 ]. In a meta-analysis, 10,233 COVID-19 patients with obesity (33.9%) had higher odds of poor outcomes than better outcomes with a pooled OR of 1.88 (95% CI: 1.25–2.80; p = 0.002) [ 73 , 74 ].…”

Obesity and Infection: What Have We Learned From the COVID-19 Pandemic

“…In a retrospective cohort study with 14,625 patients in Turkey, Sahin et al observed that hospitalization, ICU admission, intubation/ventilation, lung involvement and mortality were significantly higher in overweight and obese patients. On adjusted analysis, overweight (OR, 95% CI: 1.82, 1.04-3.21; p = 0.037) and obesity (OR, 95% CI: 2.69, 1.02-1.05; p < 0.001) were associated with a higher rate of intubation/mechanical ventilation, but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40-4.67; p = 0.002) (34).…”