Obesity: A critical risk factor in the COVID-19 pandemic.

Obesity is an emerging independent risk factor for susceptibility to and severity of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Previous viral pandemics have shown that obesity, particularly severe obesity (BMI > 40 kg/m2 ), is associated with increased risk of hospitalization, critical care admission and fatalities. In this narrative review, we examine emerging evidence of the influence of obesity on COVID-19, the challenges to clinical management from pulmonary, endocrine and immune dysfunctions in individuals with obesity and identify potential areas for further research. We recommend that people with severe obesity be deemed a vulnerable group for COVID-19; clinical trials of pharmacotherapeutics, immunotherapies and vaccination should prioritize inclusion of people with obesity.

A global country-level analysis of the relationship between obesity and COVID-19 cases and mortality.

AIM: To assess the association of country-level obesity prevalence with COVID-19 case and mortality rates, to evaluate the impact of obesity prevalence on worldwide variation. METHODS: Data on COVID-19 prevalence and mortality, country-specific governmental actions, socioeconomic, demographic, and healthcare capacity factors were extracted from publicly available sources. Multivariable negative binomial regression was used to assess the independent association of obesity with COVID-19 case and mortality rates. RESULTS: Across 168 countries for which data were available, higher obesity prevalence was associated with increased COVID-19 mortality and prevalence rates. For every 1% increase in obesity prevalence, the mortality rate was increased by 8.3% (incidence rate ratio [IRR] 1.083, 95% confidence interval [CI] 1.048-1.119; P < 0.001) and the case rate was higher by 6.6% (IRR 1.066, 95% CI 1.035-1.099; P < 0.001). Additionally, higher median population age, greater female ratio, higher Human Development Index (HDI), lower population density, and lower hospital bed availability were all significantly associated with higher COVID-19 mortality rate. In addition, stricter governmental actions, higher HDI and lower mean annual temperature were significantly associated with higher COVID-19 case rate. CONCLUSION: These findings demonstrate that obesity prevalence is a significant and potentially modifiable risk factor of increased COVID-19 national caseload and mortality. Future research to study whether weight loss improves COVID-19 outcomes is urgently required.

Exposure of hospital healthcare workers to the novel coronavirus (SARS-CoV-2).

Healthcare workers (HCWs) are at higher risk of infection with the coronavirus disease 2019 (COVID-19) and can also amplify outbreaks within healthcare facilities if they become ill. Certain groups are known to be at higher risk of contracting severe COVID-19 infection, such as men and people from Black, Asian and minority ethnic (BAME) backgrounds. Identifying and managing HCWs who have been exposed to COVID-19 is of utmost importance in preventing healthcare transmission and protecting staff and vulnerable patients in healthcare settings. Recently, antibody testing to diagnose previous COVID-19 exposure among HCW has commenced in the UK. This provided an opportunity to assess exposure to COVID-19 among the various subgroups within the HCW community, based on their roles and ethnic background. We found that HCWs working in patient-facing roles were twice as likely to have been exposed to COVID-19 than their colleagues in non-patient-facing roles. Reassuringly, workers from BAME backgrounds had a similar risk of previous COVID-19 exposure to their white colleagues. More research is required to assess how frontline staff, especially those working in patient facing roles, can reduce their risk of exposure to COVID-19.