Should patients with obesity be more afraid of COVID‐19?

Rychter, Anna M.; Zawada, Agnieszka; Ratajczak, Alicja Ewa; Dobrowolska, Agnieszka; Krela‐Kaźmierczak, Iwona

doi:10.1111/obr.13083

Cited by 66 publications

(58 citation statements)

References 91 publications

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“…Obesity impairs the ability of the adaptive immune response to cope with viral infection [ 22 ]. AT synthesizes a number of pro-inflammatory adipokines and cytokines, including interleukin (IL)-6 and IL-8, which may weaken the antiviral immune response in obese patients [ 23 ]. Furthermore, the metabolic comorbidities of obese patients, such as diabetes, could contribute to the risk of developing severe COVID-19, although the present study adjusted for possible confounding metabolic diseases, including diabetes and hypertension.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Mortality and Morbidity in COVID-19 Patients with Obesity Using Clinical Epidemiological Data from the Korean Center for Disease Control & Prevention

Kim

Yoo

Min

et al. 2020

IJERPH

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Previous studies have reported the association of obesity with increased morbidity or mortality due to the coronavirus disease 2019 (COVID-19). This study aims to investigate the relationship of obesity, as defined by the body mass index (BMI), with morbidity and mortality due to COVID-19. Data from 5628 confirmed COVID-19 patients were collected by the Centers for Disease Control and Prevention of Korea. The hazard ratios (HRs) for mortality in the BMI groups were analyzed using the Cox proportional hazard model adjusted for covariates. The odds ratios (ORs) of morbidity and diabetes in the BMI groups were analyzed using logistic regression adjusted for the same covariates. Both underweight and obesity were associated with a higher HR for mortality (adjusted HR = 2.28, 95% confidence intervals [95% CI] = 1.23–4.25, p = 0.009 for underweight and adjusted HR = 1.71, 95% CI = 1.10–2.66, p = 0.017 for obese). Obesity was related to higher odds of morbidity (adjusted OR = 1.71, 95% CI = 1.32–2.21, p < 0.001). Underweight and obesity were associated with high mortality and/or morbidity due to COVID-19 in Korea.

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Section: Discussionmentioning

confidence: 99%

Analysis of Mortality and Morbidity in COVID-19 Patients with Obesity Using Clinical Epidemiological Data from the Korean Center for Disease Control & Prevention

Kim

Yoo

Min

et al. 2020

IJERPH

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“… 65 The pressure exerted by abdominal adiposity on the lungs, through the diaphragm, also acts to limit the movement of respiratory muscles, with less oxygen saturation 66 and worsening clinical presentation due to the lower lung volume of obese patients. 67 In addition, some comorbidities linked to obesity may contribute to a higher risk of pulmonary infections, such as the presence of asthma, which is highly prevalent among obese children, 68 and obstructive sleep apnea. 69 Regarding asthma, the same inflammatory mechanisms linked to leptin and IL-2, which explain the high prevalence and severity of this disease in obese children, 70 are also involved in the severity of COVID-19.…”

Section: Pathophysiology Of Obesity and Its Relationship With Covid-1mentioning

confidence: 99%

COVID-19 and obesity in childhood and adolescence: a clinical review

Nogueira‐de‐Almeida

Ciampo

Ferraz

et al. 2020

Jornal de Pediatria

174

136

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Objective To identify factors that contribute to the increased susceptibility and severity of COVID-19 in obese children and adolescents, and its health consequences. Sources Studies published between 2000 and 2020 in the PubMed, MEDLINE, Scopus, SciELO, and Cochrane databases. Summary of findings Obesity is a highly prevalent comorbidity in severe cases of COVID-19 in children and adolescents; social isolation may lead to increase fat accumulation. Excessive adipose tissue, deficit in lean mass, insulin resistance, dyslipidemia, hypertension, high levels of proinflammatory cytokines, and low intake of essential nutrients are factors that compromise the functioning of organs and systems in obese individuals. These factors are associated with damage to immune, cardiovascular, respiratory, and urinary systems, along with modification of the intestinal microbiota (dysbiosis). In severe acute respiratory syndrome coronavirus 2 infection, these organic changes from obesity may increase the need for ventilatory assistance, risk of thromboembolism, reduced glomerular filtration rate, changes in the innate and adaptive immune response, and perpetuation of the chronic inflammatory response. Conclusions The need for social isolation can have the effect of causing or worsening obesity and its comorbidities, and pediatricians need to be aware of this issue. Facing children with suspected or confirmed COVID-19, health professionals should 1) diagnose excess weight; 2) advise on health care in times of isolation; 3) screen for comorbidities, ensuring that treatment is not interrupted; 4) measure levels of immunonutrients; 5) guide the family in understanding the specifics of the situation; and 6) refer to units qualified to care for obese children and adolescents when necessary.

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“…Recent studies from Europe, the United States and China have identified obesity as an independent risk factor for the most severe outcomes of COVID‐19, including death 6‐14 . A nationwide Danish study 6 of 11 122 individuals with a positive polymerase chain reaction test for SARS‐CoV‐2 found hospitalization rates of 20% among all patients and 29% among patients with overweight or obesity.…”

Section: Introductionmentioning

confidence: 99%

Costs of the COVID‐19 pandemic associated with obesity in Europe: A health‐care cost model

et al. 2021

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Summary Excess weight is associated with severe outcomes of coronavirus disease 2019 (COVID‐19). We aimed to estimate the total secondary care costs by body mass index (BMI, kg/m2) category when hospitalized due to COVID‐19 in Europe during the first wave of the pandemic from January to June 2020. Building a health‐care cost model, this study aimed to estimate the total costs of COVID‐19. Information on risk of hospitalization, admission to intensive care unit (ICU) and risk of ventilation were based on published data. Average cost per patient and in total were calculated based on risks of admission to ICU, risk of invasive mechanical ventilation and length of hospital stay when hospitalized and published costs associated with hospitalization. The total direct costs of secondary care during the first wave of COVID‐19 in Europe were estimated at EUR 13.9 billon, whereof 76% accounted for treating people with overweight and obesity. The average cost per hospital admission increased with BMI, from EUR 15831 for BMI <25 kg/m2 to EUR 30982 for BMI ≥40 kg/m2. This study reveals that excess weight contributes disproportionally to the costs of COVID‐19. This might reflect that overweight and obesity caused the COVID‐19 pandemic to result in more severe outcomes for citizens and higher secondary care costs throughout Europe.

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Should patients with obesity be more afraid of COVID‐19?

Cited by 66 publications

References 91 publications

Analysis of Mortality and Morbidity in COVID-19 Patients with Obesity Using Clinical Epidemiological Data from the Korean Center for Disease Control & Prevention

Analysis of Mortality and Morbidity in COVID-19 Patients with Obesity Using Clinical Epidemiological Data from the Korean Center for Disease Control & Prevention

COVID-19 and obesity in childhood and adolescence: a clinical review

Costs of the COVID‐19 pandemic associated with obesity in Europe: A health‐care cost model

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