Obesity implications on SARS-CoV-2 infections' prevalence, hospitalizations, critical care needs, fatalities &amp; vaccination rates: A public health crisis

Alfaro, Sophie; Autrey, Cody; Sen-Crowe, Brendon; Elkbuli, Adel

doi:10.1016/j.amsu.2021.103096

Cited by 3 publications

(12 citation statements)

References 27 publications

(33 reference statements)

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“…Several pathophysiological mechanisms of obesity as a risk factor driving severe COVID-19 illness have been suggested ( 19 ): first, the adipose tissue has more angiotensin-converting enzyme-2 receptors, which is the site for the coronavirus entry into the cells, than does the lung tissue, so the excess adipose tissue could serve as a reservoir for the coronavirus ( 29 , 30 ). Also an excess of abdominal fat and weight impairs adequate ventilation and increases the risk for infection (including expansion of the COVID-19 infection but also secondary infections) ( 19 , 31 ), which might explain higher rates of pneumonia and ARDS of obese patients in our study. Certainly, central or abdominal obesity or visceral adipose tissue may carry a particularly “heavy” risk in COVID-19.…”

Section: Discussionmentioning

confidence: 99%

“…Last but not least, social factors may contribute to poor outcomes, including loneliness, and might be followed by a higher frequency of depressive syndromes ( 19 ). In addition, because the focus is on the healthcare system and the physicians working with the COVID-19 pandemic, other prevalent acute or chronic diseases that carry an increased risk for adverse outcomes in patients with COVID-19 infection and severe COVID-19 complications might be overlooked, be considered to be unimportant at this time, or be unnoticed ( 19 ). National lockdown measures with stay-at-home orders for longer periods favored sedentary lifestyle with distinctly reduced physical activity (PA) and exacerbated unhealthy dietary habits resulting in increased prevalence of obesity during the pandemic along with the psychological effects of social isolation ( 5 , 8 , 9 , 19 , 54 ).…”

Section: Discussionmentioning

confidence: 99%

“…Certainly, central or abdominal obesity or visceral adipose tissue may carry a particularly “heavy” risk in COVID-19. Ventilating obese patients via mask ventilation or intubation is more difficult not least because of an increased thoracic mass accompanied by a need for higher positive end-expiratory and peak pressures to maintain proper oxygenation and an increased risk of barotrauma (such as alveolar injury/rupture and pneumothorax) ( 19 , 31 ). Since our study detected a decrease regarding the necessity of ICU admissions and MV over the months of the year 2020, this could be interpreted as a learning curve of the treating physicians regarding the use of invasive treatments in obese COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Since our study detected a decrease regarding the necessity of ICU admissions and MV over the months of the year 2020, this could be interpreted as a learning curve of the treating physicians regarding the use of invasive treatments in obese COVID-19 patients. As mentioned, the effect of a weakened immune system in obese individuals by chronic inflammation due to adipose tissue and by dysregulation of pro-inflammatory cytokines might predispose obese COVID-19 patients to more severe infections ( 13 , 15 , 19 , 45 ). Last but not least, social factors may contribute to poor outcomes, including loneliness, and might be followed by a higher frequency of depressive syndromes ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…Coding according to the German Diagnosis Related Groups (G-DRG) system with the coding of patient data on diagnoses, coexisting conditions, and surgeries as well as diagnostic and interventional procedures is required, and the transfer of these codes to the Institute for the Hospital Remuneration System is mandatory for German hospitals to get their remuneration regarding rendered and provided services ( 15 , 16 ). In this context, patients’ diagnoses are coded according to the International Statistical Classification of Diseases and Related Health Problems (of the 10th revision with German modification, ICD-10-GM) ( 19 , 20 ). In addition, diagnostic, interventional, and surgical procedures are coded according to special OPS codes [Operationen- und Prozedurenschlüssel (surgical and procedural coding).…”

Section: Methodsmentioning

confidence: 99%

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Obesity and Its Impact on Adverse In-Hospital Outcomes in Hospitalized Patients With COVID-19

et al. 2022

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BackgroundAn increasing level of evidence suggests that obesity not only is a major risk factor for cardiovascular diseases (CVDs) but also has adverse outcomes during COVID-19 infection.MethodsWe used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19 diagnosis in Germany from January to December 2020 and stratified them for diagnosed obesity. Obesity was defined as body mass index ≥30 kg/m2 according to the WHO. The impact of obesity on in-hospital case fatality and adverse in-hospital events comprising major adverse cardiovascular and cerebrovascular events (MACCE), acute respiratory distress syndrome (ARDS), venous thromboembolism (VTE), and others was analyzed.ResultsWe analyzed data of 176,137 hospitalizations of patients with confirmed COVID-19 infection; among them, 9,383 (5.3%) had an additional obesity diagnosis. Although COVID-19 patients without obesity were older (72.0 [interquartile range (IQR) 56.0/82.0] vs. 66.0 [54.0/76.0] years, p < 0.001), the CVD profile was less favorable in obese COVID-19 patients (Charlson comorbidity index 4.44 ± 3.01 vs. 4.08 ± 2.92, p < 0.001). Obesity was independently associated with increased in-hospital case fatality (OR 1.203 [95% CI 1.131–1.279], p < 0.001) and MACCE (OR 1.168 [95% CI 1.101–1.239], p < 0.001), ARDS (OR 2.605 [95% CI 2.449–2.772], p < 0.001), and VTE (OR 1.780 [95% CI 1.605–1.973], p < 0.001) and also associated with increased necessity of treatment on intensive care unit (OR 2.201 [95% CI 2.097–2.310], p < 0.001), mechanical ventilation (OR 2.277 [95% CI 2.140–2.422], p < 0.001), and extracorporeal membrane oxygenation (OR 3.485 [95% CI 3.023–4.017], p < 0.001).ConclusionsObesity independently affected case fatality, MACCE, ARDS development, VTE, and other adverse in-hospital events in patients with COVID-19 infection. Obesity should be taken into account regarding COVID-19 prevention strategies, risk stratification, and adequate healthcare planning. Maintaining a healthy weight is important not only to prevent cardiometabolic diseases but also for better individual outcomes during COVID-19 infection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Obesity and Its Impact on Adverse In-Hospital Outcomes in Hospitalized Patients With COVID-19

et al. 2022

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Post-vaccination and post-infectious immune response against new coronavirus infection on the background of obesity and overweight

Klimchuk,

Beloglazov,

Yatskov

et al. 2023

Obes. metabol.

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In the fall of 2019, global health was confronted with a new RNA virus — severe acute respiratory syndrome coronavirus 2 SARS-CoV-2. Against the background of the rapid spread of infection, research centers around the world began to develop specific vaccines against COVID-19, using the accumulated experience and empirical data on the stereotypes of the structure and physiology of other viral agents of this family (severe acute respiratory syndrome virus (SARS) and Middle East respiratory syndrome (MERS). However, even before the development of anti-COVID vaccines, it was suggested that they are probably less effective in a number of individuals, in particular, in people who are overweight or obese. This hypothesis arose on the basis of past studies using vaccines for other purposes in this categories of people, as well as in numerous experiments on mice, thanks to which scientists came to the conclusion that, due to an excess amount of adipose tissue in the body, there is a state of a permanent inflammatory process, some immune dysfunction, and, as a result, a reduced local and systemic response. resistance against bacterial and viral agents.In this literature review, using current publications obtained by searching for “covid-19 vaccination and obesity” and “vaccination and obesity” in the PubMed databases and “covid-19 vaccination and obesity” and “vaccination and obesity” in the e- Library discusses changes in the immune response both to infection itself and to immunization in the presence of overweight or obesity.

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Temporal Trends in Patients with Peripheral Artery Disease Influenced by COVID-19 Pandemic

Keller

Schmitt

Hobohm

et al. 2022

JCM

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Background: The COVID-19 pandemic influences the health care management of acute and chronic diseases. Data concerning the influence of the pandemic on hospitalizations of patients with peripheral artery disease (PAD) are sparse. Methods: We analysed all patients hospitalized due to PAD between 1 January 2019 and 31 December 2020 in Germany. Hospitalizations of PAD patients during the pre-pandemic year 2019 were compared to the pandemic year 2020. Results: Overall, 361,029 hospitalizations of PAD patients in the years 2019 and 2020 (55.4% aged ≥70 years; 36.6% females) were included in this study. In the pre-pandemic year of 2019, a total of 25,501 (13.2%) more hospitalizations due to PAD were detected compared to the COVID-19 pandemic year of 2020 (2019: 192,765 [53.4%] vs. 2020: 168,264 [46.6%], p = 0.065). Overall, in 610 (0.4%) of the hospitalization cases, a COVID-19 infection was diagnosed. Regarding interventional/surgical treatments, total numbers of peripheral endovascular intervention of the lower extremity decreased by 9.9% (83,845 vs. 75,519, p < 0.001), surgical peripheral artery revascularization of the lower extremity by 11.4% (32,447 vs. 28,754, p = 0.041) and amputations by 4.0% (20,612 vs. 19,784, p < 0.001) in 2020 compared to 2019. The case fatality rate (2.6% vs. 2.4%, p < 0.001), as well as MACCE rate (3.4% vs. 3.2%, p < 0.001), were slightly higher during the pandemic year 2020 compared to the pre-pandemic year 2019. Conclusions: The COVID-19 pandemic influenced the number of hospitalizations of PAD patients with a 13.2% reduction in hospital admissions and decreased total numbers of revascularization and amputation treatments.

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Obesity implications on SARS-CoV-2 infections' prevalence, hospitalizations, critical care needs, fatalities & vaccination rates: A public health crisis

Cited by 3 publications

References 27 publications

Obesity and Its Impact on Adverse In-Hospital Outcomes in Hospitalized Patients With COVID-19

Obesity and Its Impact on Adverse In-Hospital Outcomes in Hospitalized Patients With COVID-19

Post-vaccination and post-infectious immune response against new coronavirus infection on the background of obesity and overweight

Temporal Trends in Patients with Peripheral Artery Disease Influenced by COVID-19 Pandemic

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