Independent Role of Severe Obesity as a Risk Factor for COVID‐19 Hospitalization: A Spanish Population‐Based Cohort Study

Martín, Carlos González; Navascués, Ana; Portillo, María Eugenia; Polo, Isabel; Ezpeleta, Carmen; Albéniz, Esther; Elía, Fernando; Gorricho, J; Ardanáz, Eva; Ascunce, Nieves; Arriazu, Maite; Barricarte, Aurelio; Barriuso, L.; Burgui, Cristina; Casado, Itziar; Díaz, Jorge; Ederra, María; Egüés, Nerea; Fresán, Ujué; Garde, Carmen; Gómez‐Ibáñez, Carlos; Cenoz, Manuel García; García, Vega; Guevara, Marcela; Iriarte, Nerea; Martínez‐Baz, Iván; Moreno‐Iribas, Conchi; Sayón, Carmen; Vidán, Juana; Castilla, Jesús

doi:10.1002/oby.23029

Cited by 51 publications

(52 citation statements)

References 45 publications

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“…Our results are consistent with many other studies showing the increased risk of severe COVID-19 outcomes among patients with major chronic conditions [13][14][15][16][17]28]. Almost all major chronic conditions were independent risk factors for COVID-19 hospitalization; asthma, severe obesity and hypertension were also related to intensive care unit admission; and several major chronic conditions were risk factors for COVID-19 mortality.…”

Section: Discussionsupporting

confidence: 91%

Risk Factors of Infection, Hospitalization and Death from SARS-CoV-2: A Population-Based Cohort Study

Castilla

Guevara

Miqueleiz

et al. 2021

JCM

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We conducted a prospective population-based cohort study to assess risk factors for infection, hospitalization, and death from SARS-CoV-2. The study comprised the people covered by the Health Service of Navarre, Spain. Sociodemographic variables and chronic conditions were obtained from electronic healthcare databases. Confirmed infections, hospitalizations, and deaths from SARS-CoV-2 were obtained from the enhanced epidemiological surveillance during the second SARS-CoV-2 epidemic surge (July–December 2020), in which diagnostic tests were widely available. Among 643,757 people, 5497 confirmed infections, 323 hospitalizations, 38 intensive care unit admissions, and 72 deaths from SARS-CoV-2 per 100,000 inhabitants were observed. A higher incidence of confirmed infection was associated with people aged 15–29 years, nursing home residents, healthcare workers, people born in Latin America or Africa, as well as in those diagnosed with diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease, dementia, severe obesity, hypertension and functional dependence. The risk of hospitalization in the population was associated with males, higher age, nursing home residents, Latin American or African origin, and those diagnosed with immunodeficiency, diabetes, cardiovascular disease, COPD, asthma, kidney disease, cerebrovascular disease, cirrhosis, dementia, severe obesity, hypertension and functional dependence. The risk of death was associated with males, higher age, nursing home residents, Latin American origin, low income level, immunodeficiency, diabetes, cardiovascular disease, COPD, kidney disease, dementia, and functional dependence. This study supports the prioritization of the older population, nursing home residents, and people with chronic conditions and functional dependence for SARS-CoV-2 prevention and vaccination, and highlights the need for additional preventive support for immigrants.

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Section: Discussionsupporting

confidence: 91%

Risk Factors of Infection, Hospitalization and Death from SARS-CoV-2: A Population-Based Cohort Study

Castilla

Guevara

Miqueleiz

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

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“…The median age of patients was 60 years old (IQR 47-73 years). Obese patients with a BMI ≥30 represented almost half the population, consistent with evidence that obesity is a risk factor for hospitalization with COVID-19 (37). Racial and ethnic demographics vary immensely across the literature.…”

Section: Discussionsupporting

confidence: 72%

Statins Are Associated with Improved 28-day Mortality in Patients Hospitalized with SARS-CoV-2 Infection

Memel

Lee

et al. 2021

Preprint

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Background: Statins may be protective in viral infection and have been proposed as treatment in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Objective: We evaluated the effect of statins on mortality in four groups hospitalized with (SARS-CoV-2) infection (continued statin, newly initiated statin, discontinued statin, never on statin). Design: In a single center cohort study of 1179 patients hospitalized with SARS-CoV-2 infection, the outcome of death, Intensive Care Unit (ICU) admission or hospital discharge was evaluated. Patients statin use, laboratory data, and co-morbidities were determined via chart review and electronic health records. Using marginal structural models to account for timing of statin initiation and competing risks, we compared the likelihood of severe outcomes in the four statin exposure groups. Setting: Academic medical center in the United States Participants: Patients hospitalized with SARS-CoV-2 infection Measurements: 28-day mortality, ICU admission, or discharge Results: Among 1179 patients, 360 were never on a statin, 311 were newly initiated on a statin, 466 were continued on a statin, and 42 had a statin discontinued. In this cohort, 154 (13.1%) patients died by 28-days. With marginal structural model analysis, statin use reduced the hazard of 28-day mortality (HR 0.566 [CI 0.372, 0.862], p = 0.008). Both new initiation of statins (HR 0.493 [CI 0.253, 0.963], p=0.038) and continuing statin therapy reduced the hazard of 28-day mortality (HR 0.270 [CI 0.114, 0.637], p=0.003). Sensitivity analysis found that statin use was associated with improved mortality for patients > 65 years, but not for patients 65 years or younger. Limitation: Observational design Conclusion: Statin therapy during hospitalization for SARS-CoV-2 infection, including new initiation and continuation of therapy, was associated with reduced short-term mortality.

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“…In a large cohort study of 433 995 COVID‐19 patients, obese patients were at increased risk of hospitalization (adjusted relative risk [aRR]: 2.20) and severity (aRR: 2.30). This was not observed in patients aged 65‐79 years but was notable in the population younger than 50 years (aRR: 5.02 and 13.80, respectively) 76 . Similarly, Gao et al reported a higher severity and longer hospital stay in obese COVID‐19 patients, which has positively correlated with BMI (aOR: 3.00 for obesity, aOR: 1.13 for BMI) 77 .…”

Section: Comorbiditiesmentioning

confidence: 92%

Risk factors for severe and critically ill COVID‐19 patients: A review

Gao

Ding

Dong

et al. 2020

Allergy

1,007

864

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The pandemic of coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID‐19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID‐19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high‐sensitivity C‐reactive protein, proinflammatory cytokines such as interleukin (IL)‐6, IL‐1β, Krebs von den Lungen‐6 (KL‐6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID‐19.

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Independent Role of Severe Obesity as a Risk Factor for COVID‐19 Hospitalization: A Spanish Population‐Based Cohort Study

Cited by 51 publications

References 45 publications

Risk Factors of Infection, Hospitalization and Death from SARS-CoV-2: A Population-Based Cohort Study

Risk Factors of Infection, Hospitalization and Death from SARS-CoV-2: A Population-Based Cohort Study

Statins Are Associated with Improved 28-day Mortality in Patients Hospitalized with SARS-CoV-2 Infection

Risk factors for severe and critically ill COVID‐19 patients: A review

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