1/

Curious about the links between #overweight, #obesity, and #COVIDー19?

Let’s go one layer deeper than the headlines.

Here is a summary of the data so far reported in accepted manuscripts and pre-prints from large academic medical centers.

2/

Cai et al. studied 383 COVID-19 patients admitted to Third People’s Hospital in Shenzen .

At baseline, 32% were overweight and 10.7% were obese.

Obese patients had 2.42-fold higher odds of developing severe pneumonia.

3/

Interestingly, the data indicate that obese men were particularly susceptible to developing severe pneumonia.

They had an odds ratio of 5.70!

4/

Notes:

In East Asia overweight is BMI > 24 and obesity is BMI > 28, compared to cut-offs of 25 and 30 elsewhere.

The multivariate model was adjusted for history of including hypertension and diabetes

Retrospective design at a single center with no historical controls

5/

Here is the pre-print submitted to The Lancet Infectious Diseases:

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3556658

6/

Simonnet et al. studied 124 consecutive patients admitted for ICU care at @CHU_Lille.

These patients were also compared to a historical control group of 306 patients admitted to the ICU for severe acute respiratory disease earlier in 2019.

7/

At baseline, 48% had BMI > 30 and 28% had BMI > 35.

86% of patients with BMI > 35 required invasive mechanical ventilation (IMV).

8/

The odds ratio for IMV in patients with BMI > 35 vs BMI < 25 was 7.36!

9/

Interestingly, BMI distribution for SARS-CoV-2 patients was markedly different than in the historical cohort, skewing heavily toward higher BMI.

10/

Notes:

Results remained significant in the multivariate model after adjusting for age, diabetes, and hypertension.

Retrospective design at a single center.

11/

Here is the accepted manuscript to appear in the official journal of the @ObesitySociety: https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22831

12/

Lighter et al. reports on 3,615 individuals who were PCR-positive for COVID-19 at @nyulangone.

At baseline, 21% had BMI 30-34 and 16% had BMI > 35.

431 (12%) were transferred or admitted to the ICU.

13/

For those > 60 y/o, there was no correlation with BMI and ICU admission.

For those < 60 y/o, patients with BMI 30-34 were 1.8X more likely to be admitted to ICU.

Patients with BMI > 35 were 3.6X more likely!

14/

Notes:

Retrospective design with no historical controls

Manuscript does not detail the criteria used to admit patients to acute care or ICU

15/

Here is the accepted manuscript from Clinical Infectious Diseases: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa415/5818333

16/

Bottom line: #overweight and #obesity appear to be correlated to more severe manifestations of #COVIDー19 and ICU-level care. While younger individuals typically fare better from COVID-19, obesity may exacerbate the issue in this population.

17/

This underscores the importance of being mindful of weight while we are under quarantine and taking proactive steps to protect ourselves in the event of a #secondwave.

BMI and weight matter here and providers should be mindful of this as they start seeing patients again!