Obesity predisposes to the risk of higher mortality in young COVID‐19 patients

Abstract

Although emerging data demonstrated mortality of young COVID-19 patients, no data have reported the risk factors of mortality for these young patients, and whether obesity is a risk for young COVID-19 patients remains unknown. We conducted a retrospective study including 13 young patients who died of COVID-19 and 40 matched survivors. Logistic regression was employed to characterize the risk factors of mortality in young obese COVID-19 patients. Most of the young deceased COVID-19 patients were mild cases at the time of admission, but the disease progressed rapidly featured by a higher severity of patchy shadows (100.00% vs 48.70%; P = .006), pleural thickening (61.50% vs 12.80%; P = .012), and mild pericardial effusion (76.90% vs 0.00%; P < .001). Most importantly, the deceased patients manifested higher body mass index (odds ratio [OR] = 1.354; 95% confidence interval [CI] = 1.075-1.704; P = .010), inflammation-related index C-reactive protein (OR = 1.014; 95% CI = 1.003-1.025; P = .014), cardiac injury biomarker hs-cTnI (OR = 1.420; 95% CI = 1.112-1.814; P = .005), and increased coagulation activity biomarker D-dimer (OR = 418.7; P = .047), as compared with that of survivors. Our data support that obesity could be a risk factor associated with high mortality in young COVID-19 patients, whereas aggravated inflammatory response, enhanced cardiac injury, and increased coagulation activity are likely to be the mechanisms contributing to the high mortality.

Bariatric Surgery Closure During COVID-19 Lockdown in Italy: The Perspective of Waiting List Candidates

“…This phenomenon is clearly demonstrated in the scientific literature. Patients with obesity and metabolic syndrome are at greater risk of COVID-19 complications, which can be harmful even in young people (16). In this setting, various mechanisms have been suggested to increase the risk from viral infections, including reduced natural killer cell number and activity, impaired antigen-stimulation responses and low-grade chronic inflammation (17).…”

COVID-19 and Obesity: Dangerous Liaisons

“…In a USA study that had children and adolescents hospitalized with COVID-19 obesity was significantly associated with disease severity [33]. A retrospective case-control study of young Chinese patients with COVID-19 showed that obesity was the most important critical factor contributing to their death [34].…”

Revisión sobre obesidad como factor de riesgo para mortalidad por COVID-19

“…El IMC de los casos mortales por COVID-19 se reportó con valores cuantitativos en medias o medianas, o como variables categóricas en porcentajes. En general, el punto de corte para obesidad fue de un IMC ≥ 30 kg/m 2 con excepción de un estudio de China [26] que utilizó un valor de IMC ≥ 28 kg/m 2 . El porcentaje de obesidad (IMC ≥ 30 kg/m 2 ) se reportó en siete estudios [27][28][29][30][31][32] y los valores se encontraron entre el 10,5 % y el 33,3 %.…”

“…El efecto de la obesidad en la mortalidad por COVID-19 se reportó en 10 estudios [26][27][28][29][30][31][32][33][34][35] (Tabla 3). Dos estudios [28,33] presentaron HR para reportar a la obesidad como factor de riesgo para mortalidad comparados con personas no obesas (IMC < 30 Kg/m 2 ) y otros dos estudios [29,31] presentaron medidas para obesidad grados II y III.…”