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Sarcopenic obesity and the risk of hospitalization or death from coronavirus disease 2019: findings from UK Biobank.
Wilkinson, Thomas J; Yates, Thomas; Baker, Luke A; Zaccardi, Francesco; Smith, Alice C.
  • Wilkinson TJ; Leicester Kidney Lifestyle Team, Department of Health Sciences University of Leicester Leicester UK.
  • Yates T; Leicester NIHR Biomedical Research Centre Leicester UK.
  • Baker LA; Leicester NIHR Biomedical Research Centre Leicester UK.
  • Zaccardi F; Leicester Diabetes Research Centre Leicester UK.
  • Smith AC; Leicester Kidney Lifestyle Team, Department of Health Sciences University of Leicester Leicester UK.
JCSM Rapid Commun ; 2021 Jul 03.
Article in English | MEDLINE | ID: covidwho-1293324
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ABSTRACT

Background:

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The role of skeletal muscle mass in modulating immune response is well documented. Whilst obesity is well established as a key factor in COVID-19 and outcome, no study has examined the influence of both sarcopenia (low muscle mass) and obesity, termed 'sarcopenic obesity' on the risk of severe COVID-19.

Methods:

This study uses data from UK Biobank. Probable sarcopenia was defined as low handgrip strength. Sarcopenic obesity was mutually exclusively defined as the presence of obesity and low muscle mass [based on two established criteria appendicular lean mass (ALM) adjusted for either (i) height or (ii) body mass index]. Severe COVID-19 was defined by a positive severe acute respiratory syndrome coronavirus 2 test result in a hospital setting and/or death with a primary cause reported as COVID-19. Fully adjusted logistic regression models were used to analyse the associations between sarcopenic status and severe COVID-19. This work was conducted under UK Biobank Application Number 52553.

Results:

We analysed data from 490 301 UK Biobank participants (median age 70.0 years, 46% male); 2203 (0.4%) had severe COVID-19. Individuals with probable sarcopenia were 64% more likely to have had severe COVID-19 (odds ratio 1.638; P < 0.001). Obesity increased the likelihood of severe COVID-19 by 76% (P < 0.001). Using either ALM index or ALM/body mass index to define low muscle mass, those with sarcopenic obesity were 2.6 times more likely to have severe COVID-19 (odds ratio 2.619; P < 0.001). Sarcopenia alone did not increase the risk of COVID-19.

Conclusions:

Sarcopenic obesity may increase the risk of severe COVID-19, over that of obesity alone. The mechanisms for this are complex but could be a result of a reduction in respiratory functioning, immune response, and ability to respond to metabolic stress.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Diagnostic study / Etiology study / Prognostic study / Risk factors Language: English Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Diagnostic study / Etiology study / Prognostic study / Risk factors Language: English Clinical aspect: Etiology Year: 2021
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