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Impact of obesity on COVID-19 outcomes

Last updated 05-06-2020

As the impact of COVID-19 continues to be felt around the world, this page provides links to emerging evidence that suggests obesity may be a risk factor for becoming seriously ill with the virus. Unlike other pages on the hub, this page is not a synthesis of the evidence, rather it is a central place to source relevant studies. Studies showing links between obesity and hospitalisation, critical illness, use of mechanical ventilation and death are provided below. These studies may not have been evaluated for their quality (how methodologically sound), given the evidence is at an early stage.

Rationale

  • This letter to the editor discusses evidence from the H1N1 influenza pandemic showing that people with obesity represented a large proportion of those hospitalised and who were seriously ill and died. It cautions the likely similarities with COVID-19 and discusses the significance of this for the U.S with its high rates of obesity (Dietz and Santos-Burgoa, 2020)
    https://onlinelibrary.wiley.com/doi/10.1002/oby.22818

Hospitalisation/critical illness

  • An analysis of general population data from 387,109 adults in the United Kingdom (UK Biobank study), found that overweight and obesity were strongly associated with hospitalisation with the novel coronavirus (Hamer, Kivimaki et al, 2020)
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245300/
  • A study of 340 patients admitted to a hospital in Lyon, France, with severe COVID-19 found a higher rate of obesity than in the general French population. There were also higher rates of obesity among patients requiring intensive care treatment for COVID-19, compared to the general French population. (Caussy, Pattou et al, 2020)
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234780/

Mechanical ventilation

  • This study of 124 patients admitted to intensive care in a French hospital with COVID-19 found a high frequency of obesity and disease severity increased with body mass index (BMI). The need for invasive mechanical ventilation was associated with severe obesity (Simonnet, Chetboun et al, 2020)
    https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.22831

Death

  • This study of 3406 patients admitted to hospital in New York City with COVID-19 found patients younger than 50 with morbid obesity are far more likely to die from the novel coronavirus than others hospitalised with the virus in this age group (Klang, Kassim et al, 2020)
    https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22913