Obesity as a Risk Factor for Severe COVID-19: Summary of the Best Evidence and Implications for Health Care

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Purpose of Review

To collate the best evidence from several strands—epidemiological, genetic, comparison with historical data and mechanistic information—and ask whether obesity is an important causal and potentially modifiable risk factor for severe COVID-19 outcomes.

Recent Findings

Several hundred studies provide powerful evidence that body mass index (BMI) is a strong linear risk factor for severe COVID-19 outcomes, with recent studies suggesting ~5-10% higher risk for COVID-19 hospitalisation per every kg/m ² higher BMI. Genetic data concur with hazard ratios increasing by 14% per every kg/m ² higher BMI. BMI to COVID-19 links differ markedly from prior BMI-infection associations and are further supported as likely causal by multiple biologically plausible pathways.

Summary

Excess adiposity appears to be an important, modifiable risk factor for adverse COVID-19 outcomes across all ethnicities. The pandemic is also worsening obesity levels. It is imperative that medical systems worldwide meet this challenge by upscaling investments in obesity prevention and treatments.

Related collections

Most cited references 32

Record: found
Abstract: found
Article: found

Is Open Access

OpenSAFELY: factors associated with COVID-19 death in 17 million patients

Elizabeth J Williamson, Alex J Walker, Krishnan Bhaskaran … (2020)

COVID-19 has rapidly impacted on mortality worldwide. 1 There is unprecedented urgency to understand who is most at risk of severe outcomes, requiring new approaches for timely analysis of large datasets. Working on behalf of NHS England we created OpenSAFELY: a secure health analytics platform covering 40% of all patients in England, holding patient data within the existing data centre of a major primary care electronic health records vendor. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19 related deaths. COVID-19 related death was associated with: being male (hazard ratio 1.59, 95%CI 1.53-1.65); older age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared to people with white ethnicity, black and South Asian people were at higher risk even after adjustment for other factors (HR 1.48, 1.29-1.69 and 1.45, 1.32-1.58 respectively). We have quantified a range of clinical risk factors for COVID-19 related death in the largest cohort study conducted by any country to date. OpenSAFELY is rapidly adding further patients’ records; we will update and extend results regularly.

0 comments Cited 3015 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Once-Weekly Semaglutide in Adults with Overweight or Obesity

John P.H. Wilding, Rachel L. Batterham, Salvatore Calanna … (2021)

Obesity is a global health challenge with few pharmacologic options. Whether adults with obesity can achieve weight loss with once-weekly semaglutide at a dose of 2.4 mg as an adjunct to lifestyle intervention has not been confirmed.

0 comments Cited 797 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents

Neil Murphy, George Davey Smith (2017)

Summary Background Overweight and obesity are increasing worldwide. To help assess their relevance to mortality in different populations we conducted individual-participant data meta-analyses of prospective studies of body-mass index (BMI), limiting confounding and reverse causality by restricting analyses to never-smokers and excluding pre-existing disease and the first 5 years of follow-up. Methods Of 10 625 411 participants in Asia, Australia and New Zealand, Europe, and North America from 239 prospective studies (median follow-up 13·7 years, IQR 11·4–14·7), 3 951 455 people in 189 studies were never-smokers without chronic diseases at recruitment who survived 5 years, of whom 385 879 died. The primary analyses are of these deaths, and study, age, and sex adjusted hazard ratios (HRs), relative to BMI 22·5–<25·0 kg/m2. Findings All-cause mortality was minimal at 20·0–25·0 kg/m2 (HR 1·00, 95% CI 0·98–1·02 for BMI 20·0–<22·5 kg/m2; 1·00, 0·99–1·01 for BMI 22·5–<25·0 kg/m2), and increased significantly both just below this range (1·13, 1·09–1·17 for BMI 18·5–<20·0 kg/m2; 1·51, 1·43–1·59 for BMI 15·0–<18·5) and throughout the overweight range (1·07, 1·07–1·08 for BMI 25·0–<27·5 kg/m2; 1·20, 1·18–1·22 for BMI 27·5–<30·0 kg/m2). The HR for obesity grade 1 (BMI 30·0–<35·0 kg/m2) was 1·45, 95% CI 1·41–1·48; the HR for obesity grade 2 (35·0–<40·0 kg/m2) was 1·94, 1·87–2·01; and the HR for obesity grade 3 (40·0–<60·0 kg/m2) was 2·76, 2·60–2·92. For BMI over 25·0 kg/m2, mortality increased approximately log-linearly with BMI; the HR per 5 kg/m2 units higher BMI was 1·39 (1·34–1·43) in Europe, 1·29 (1·26–1·32) in North America, 1·39 (1·34–1·44) in east Asia, and 1·31 (1·27–1·35) in Australia and New Zealand. This HR per 5 kg/m2 units higher BMI (for BMI over 25 kg/m2) was greater in younger than older people (1·52, 95% CI 1·47–1·56, for BMI measured at 35–49 years vs 1·21, 1·17–1·25, for BMI measured at 70–89 years; pheterogeneity<0·0001), greater in men than women (1·51, 1·46–1·56, vs 1·30, 1·26–1·33; pheterogeneity<0·0001), but similar in studies with self-reported and measured BMI. Interpretation The associations of both overweight and obesity with higher all-cause mortality were broadly consistent in four continents. This finding supports strategies to combat the entire spectrum of excess adiposity in many populations. Funding UK Medical Research Council, British Heart Foundation, National Institute for Health Research, US National Institutes of Health.

0 comments Cited 607 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Naveed Sattar:

ORCID: http://orcid.org/0000-0002-1604-2593

Naveed.Sattar@glasgow.ac.uk

Journal

Journal ID (nlm-ta): Curr Obes Rep

Journal ID (iso-abbrev): Curr Obes Rep

Title: Current Obesity Reports

Publisher: Springer US (New York )

ISSN (Electronic): 2162-4968

Publication date (Electronic): 10 August 2021

Publication date PMC-release: 10 August 2021

Pages: 1-8

Affiliations

[1 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, , University of Glasgow, ; 126 University Place, Glasgow, G12 8TA UK

[2 ]GRID grid.451052.7, ISNI 0000 0004 0581 2008, NHS England & Improvement, ; London, UK

[3 ]GRID grid.417895.6, ISNI 0000 0001 0693 2181, Department of Diabetes and Endocrinology, St Mary’s Hospital, , Imperial College Healthcare NHS Trust, ; London, UK

[4 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Division of Metabolism, Digestion and Reproduction, , Imperial College London, ; London, UK

Author information

Naveed Sattar http://orcid.org/0000-0002-1604-2593

Article

Publisher ID: 448

DOI: 10.1007/s13679-021-00448-8

PMC ID: 8353061

PubMed ID: 34374955

SO-VID: 2c474acd-43d9-46f8-884f-f7a4703b6a4f

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Obesity as a Risk Factor for Severe COVID-19: Summary of the Best Evidence and Implications for Health Care

Read this article at

Abstract

Purpose of Review

Recent Findings

Summary

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 32

OpenSAFELY: factors associated with COVID-19 death in 17 million patients

Once-Weekly Semaglutide in Adults with Overweight or Obesity

Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Comments

Comment on this article

Similar content 95

Cited by 27

Most referenced authors 854