Obesity & genetic predisposition with COVID-19

Abstract

Objective

We aimed to examine the associations of obesity-related traits (body mass index [BMI], central obesity) and their genetic predisposition with the risk of developing severe COVID-19 in a population-based data.

Research Design and Methods.

We analyzed data from 489,769 adults enrolled in the UK Biobank—a population-based cohort study. The exposures of interest are BMI categories and central obesity (e.g., larger waist circumference). Using genome-wide genotyping data, we also computed polygenic risk scores (PRSs) that represent an individual's overall genetic risk for each obesity trait. The outcome was severe COVID-19, defined by hospitalization for laboratory-confirmed COVID-19.

Results

Of 489,769 individuals, 33% were normal weight (BMI, 18.5–24.9 kg/m ²), 43% overweight (25.0–29.9 kg/m ²), and 24% obese (≥30.0 kg/m ²). The UK Biobank identified 641 patients with severe COVID-19. Compared to adults with normal weight, those with a higher BMI had a dose-response increases in the risk of severe COVID-19, with the following adjusted ORs: for 25.0–29.9 kg/m ², 1.40 (95%CI 1.14–1.73; P = 0.002); for 30.0–34.9 kg/m ², 1.73 (95%CI 1.36–2.20; P < 0.001); for 35.0–39.9 kg/m ², 2.82 (95%CI 2.08–3.83; P < 0.001); and for ≥40.0 kg/m ², 3.30 (95%CI 2.17–5.03; P < 0.001). Likewise, central obesity was associated with significantly higher risk of severe COVID-19 (P < 0.001). Furthermore, larger PRS for BMI was associated with higher risk of outcome (adjusted OR per BMI PRS Z-score 1.14, 95%CI 1.05–1.24; P = 0.004).

Conclusions

In this large population-based cohort, individuals with more-severe obesity, central obesity, or genetic predisposition for obesity are at higher risk of developing severe-COVID-19.

Highlights

• •

  Individuals with more-severe obesity, central obesity are at higher risk of developing severe-COVID-19.

• •

  The genetic predisposition for obesity as measured by polygenic risk score is at higher risk of developing severe-COVID-19.

• •

  The stratified analysis by sex showed the BMI-severe COVID-19 associations were consistent across the strata, except women with class I obesity had a non-significant increase in the risk of severe COVID-19.

• •

  The stratified analysis by coexistent diabetes showed consistent results across the strata, while adults with both class III obesity and diabetes or adults with both a larger waist circumference and diabetes appeared to have a larger magnitude of association compared to those without diabetes.