Underweight, overweight, and obesity as independent risk factors for hospitalization in adults and children from influenza and other respiratory viruses

Abstract

BackgroundThe relationship between obesity and risk of complications described during the 2009 influenza pandemic is poorly defined for seasonal influenza and other viral causes of influenza‐like illness (ILI).MethodsAn observational cohort of hospitalized and outpatient participants with ILI was conducted in six hospitals in Mexico. Nasopharyngeal swabs were tested for influenza and other common respiratory pathogens.ResultsA total of 4778 participants were enrolled in this study and had complete data. A total of 2053 (43.0%) had severe ILI. Seven hundred and seventy‐eight (16.3%) were positive for influenza, 2636 (55.2%) were positive for other viral respiratory pathogens, and 1364 (28.5%) had no respiratory virus isolated. Adults with influenza were more likely to be hospitalized if they were underweight (OR: 5.20), obese (OR: 3.18), or morbidly obese (OR: 18.40) compared to normal‐weight adults. Obese adults with H1N1 had a sixfold increase in odds of hospitalization over H3N2 and B (obese OR: 8.96 vs 1.35, morbidly obese OR: 35.13 vs 5.58, respectively) compared to normal‐weight adults. In adults with coronavirus, metapneumovirus, parainfluenza, and rhinovirus, participants that were underweight (OR: 4.07) and morbidly obese (OR: 2.78) were more likely to be hospitalized as compared to normal‐weight adults. All‐cause influenza‐like illness had a similar but less pronounced association between underweight or morbidly obesity and hospitalization.ConclusionsThere is an increased risk of being hospitalized in adult participants that are underweight or morbidly obese, regardless of their viral pathogen status. Having influenza, however, significantly increases the odds of hospitalization in those who are underweight or morbidly obese.

Chloroquine for SARS-CoV-2: Implications of Its Unique Pharmacokinetic and Safety Properties

“…Based on the first epidemiological studies on the SARS-CoV-2 virus, it appears that co-morbidities such as diabetes mellitus and hypertension increase the risk for development of acute respiratory distress syndrome [60]. Additionally, obesity has been described as an independent risk factor for hospitalization in respiratory viral infections, including coronaviruses [61]. Therefore, it can be expected that a relatively large portion of the critically ill COVID-19 patients are (morbidly) obese.…”

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

“…Since the "Spanish" influenza pandemic of 1918, it is known that malnutrition (both underand over-nutrition) is linked to a worse prognosis of the viral infection [1]. The 1957-1960 "Asian" and the 1968 "Hong Kong" influenzas confirmed that obesity and diabetes lead to a higher mortality as well as a more prolonged duration of illness even if the subjects were without other chronic conditions that increase the risk of influenza-related complications [2,3]. During the 2009 Influenza A virus (IAV) H1N1 pandemic, obesity was also linked to increased risk of severe disease and a risk factor for hospitalization and death [4].…”

Association of Higher Body Mass Index With Severe Coronavirus Disease 2019 (COVID-19) in Younger Patients

“…Advanced age is a well-recognized risk factor for development of severe disease [1,2], however the impact of obesity on disease severity has not been thoroughly explored. Obesity was associated with increased severity and mortality in pandemic H1N1 influenza and other respiratory viruses [3,4].…”