Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

Luzi, Livio; Radaelli, Maria Grazia

doi:10.1007/s00592-020-01522-8

Cited by 335 publications

(443 citation statements)

References 39 publications

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“…Patients who suffer from obesity are known to be at increased risk of a number of conditions, including cardiometabolic and respiratory disease, contributing to a poor physiological reserve. It is already known that patients with obesity have worse outcomes from influenza infection 20,21 .…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Non-White Ethnicity, Male Sex, and Higher Body Mass Index, but Not Medications Acting on the Renin-Angiotensin System Are Associated With Coronavirus Disease 2019 (Covid-19) Hospitalisation: Review of the First 669 Cases From the Uk Biobank

Raisi‐Estabragh

McCracken

Ardissino

et al. 2020

Preprint

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Background: Cardiometabolic morbidity and medications, specifically Angiotensin ConvertingEnzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), have been linked with adverse outcomes from coronavirus disease 2019 . This study aims to investigate factors associated with COVID-19 positivity for the first 669 UK Biobank participants; compared with individuals who tested negative, and with the untested, presumed negative, rest of the population. Methods:We studied 1,474 participants from the UK Biobank who had been tested for COVID-19.Given UK testing policy, this implies a hospital setting, suggesting at least moderate to severe symptoms. We considered the following exposures: age, sex, ethnicity, body mass index (BMI), diabetes, hypertension, hypercholesterolaemia, ACEi/ARB use, prior myocardial infarction (MI), and smoking. We undertook comparisons between: 1) COVID-19 positive and COVID-19 tested negative participants; and 2) COVID-19 tested positive and the remaining participants (tested negative plus untested, n=501,837). Logistic regression models were used to investigate univariate and mutually adjusted associations.Results: Among participants tested for COVID-19, non-white ethnicity, male sex, and greater BMI were independently associated with COVID-19 positive result. Non-white ethnicity, male sex, greater BMI, diabetes, hypertension, prior MI, and smoking were independently associated with COVID-19 positivity compared to the remining cohort (test negatives plus untested). However, similar associations were observed when comparing those who tested negative for COVID-19 with the untested cohort;suggesting that these factors associate with general hospitalisation rather than specifically with COVID- 19.Conclusions: Among participants tested for COVID-19 with presumed moderate to severe symptoms in a hospital setting, non-white ethnicity, male sex, and higher BMI are associated with a positive result.

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Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Non-White Ethnicity, Male Sex, and Higher Body Mass Index, but Not Medications Acting on the Renin-Angiotensin System Are Associated With Coronavirus Disease 2019 (Covid-19) Hospitalisation: Review of the First 669 Cases From the Uk Biobank

Raisi‐Estabragh

McCracken

Ardissino

et al. 2020

Preprint

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“…Obesity is associated with a chronic low-grade inflammation that may amplify infectiondependent inflammation and promotes hyper-inflammation occurring in severe COVID-19 (2).…”

Section: Accepted Articlementioning

confidence: 99%

Special Issues for Coronavirus Disease 2019 in Children and Adolescents

Brambilla

Tosca

Filippo

et al. 2020

Obesity

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“…Many underlying conditions may leave affected individuals more vulnerable to the effects of this. Obesity, for example, tends to reduce lung function and dysregulate the immune system (24). Similarly, diabetes mellitus can impair immune function (25), as do many cancer treatments.…”

Section: Summary Of the Findingsmentioning

confidence: 99%

Age-adjusted associations between comorbidity and outcomes of COVID-19: a review of the evidence

Mason

McHale

Pennington

et al. 2020

Preprint

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Background: Current evidence suggests that older people and people with underlying comorbidities are at increased risk of severe disease and death following hospitalisation with COVID-19. As comorbidity increases with age, it is necessary to understand the age-adjusted relationship between comorbidity and COVID-19 outcomes, in order to enhance planning capabilities and our understanding of COVID-19. Methods:We conducted a rapid, comprehensive review of the literature up to 10 April 2020, to assess the international empirical evidence on the association between comorbidities and severe or critical care outcomes of COVID-19, after accounting for age, among hospitalised patients with COVID-19. Results:After screening 579 studies, we identified seven studies eligible for inclusion and these were synthesised narratively. All were from China. The emerging evidence base mostly indicates that after adjustment for age (and in some cases other potential confounders), obesity, hypertension, diabetes mellitus, chronic obstructive airways disease (COPD), and cancer are all associated with worse outcomes. The largest study, using a large nationwide sample of COVID-19 patients in China, found that those with multiple comorbidities had more than twice the risk of a severe outcome or death compared with patients with no comorbidities, after adjusting for age and smoking (HR=2.59, 95% CI 1.61, 4.17). Conclusions:This review summarises for clinicians, policymakers, and academics the most robust evidence to date on this topic, to inform the management of patients and control measures for tackling the pandemic. Given the intersection of comorbidity with ethnicity and social disadvantage, these findings also have important implications for health inequalities. As the pandemic develops, further research should confirm these trends in other settings outside China and explore mechanisms by which various underlying health conditions increase risk of severe COVID-19.

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Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

Cited by 335 publications

References 39 publications

Non-White Ethnicity, Male Sex, and Higher Body Mass Index, but Not Medications Acting on the Renin-Angiotensin System Are Associated With Coronavirus Disease 2019 (Covid-19) Hospitalisation: Review of the First 669 Cases From the Uk Biobank

Non-White Ethnicity, Male Sex, and Higher Body Mass Index, but Not Medications Acting on the Renin-Angiotensin System Are Associated With Coronavirus Disease 2019 (Covid-19) Hospitalisation: Review of the First 669 Cases From the Uk Biobank

Special Issues for Coronavirus Disease 2019 in Children and Adolescents

Age-adjusted associations between comorbidity and outcomes of COVID-19: a review of the evidence

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