Obesity and COVID-19 in Adult Patients With Diabetes

Abstract

Obesity has caused wide concerns due to its high prevalence in severe COVID-19 cases. Co-existence of diabetes and obesity could cause an even higher risk of severe outcomes due to immunity dysfunction. We conducted a retrospective study in 1637 adult patients who were admitted into an acute hospital in Wuhan, China. Propensity score matched logistic regression was used to estimate the risks of severe pneumonia and requiring in-hospital oxygen therapy associated with obesity. After adjustment for age, sex and comorbidities, obesity was significantly associated with higher odds of severe pneumonia (odd ratio [OR] 1.47 [95% CI 1.15-1.88], P=0.002) and oxygen therapy (OR 1.40 [95% CI 1.10-1.79], P=0.007). Higher ORs of severe pneumonia due to obesity were observed in men, older adults and those with diabetes. Among patients with diabetes, overweight increased the odds of requiring in-hospital oxygen therapy by 0.68 times (P=0.014) and obesity increased the odds by 1.06 times (P=0.028). A linear dose-response curve between BMI and severe outcomes was observed in all patients, whereas a U-shaped curve in those with diabetes. Our findings provide important evidence to support obesity as an independent risk factor for severe outcomes of COVID-19 infection in the early phase of the ongoing pandemic.

Prediabetes Induces More Severe Acute COVID-19 Associated With IL-6 Production Without Worsening Long-Term Symptoms

“…PDM patients in the acute phase of infection were older (67 vs 54 years) and more obese (28% vs 0%) than NDM individuals, despite a lack of statistical significance. However, the PDM individuals herein were found to have significantly higher rates of ICU admission and IMV than the NDM patients, which is concordant with age and obesity being known risk factors for severe COVID-19 ( 16 – 18 ).…”

“…We observed that PDM patients with COVID-19 required extended hospital stays [15][16][17][18][19][20][21][22]] compared to NDM [8 days (IQR 5-15)], as illustrated in Figure 1E (p = 0.044). Among the PDM COVID-19 patients, 78% were admitted to an intensive care unit (ICU), in contrast to 56% of NDM (Figure 1F).…”

Abnormal Glucose Metabolism Leads To Severe COVID-19 Due To Hyperinflammation: A Cross-Sectional Study

“…One possible explanation is that TNF-α, IL-6 and IL-8 are the main in ammatory cytokines derived from adipose tissue, and fat mass correlates signi cantly with TNF-α [39,40]. In our cohort, unlike the results of other studies [41], a linear dose-response curve between BMI and severe outcomes of COVID-19 was not observed. This nding may help reveal potential mechanistic links between obesity and worsening COVID-19.…”

A continuous age-specific standardized mortality ratio for estimating the unascertained rates in the early epidemic of COVID-19 in different regions

“…Among patients with COVID-19, circulatory diseases (including hypertension and coronary heart diseases) and endocrine diseases such as diabetes remained the most common categories of comorbidity [16][17][18]. Our previous studies also echoed with recently published studies in terms of identifying the risk factors of hypertension and diabetes in patients with COVID-19 [19,20]. We have to admit that the individual data on COVID-19 patient comorbidities status were not available in Figure 3.…”