Obesity and severity of COVID-19 infection

ABSTRACT

Background: This prospective longitudinal study evaluated the relationship of obesity among other clinical factors in relation to the subsequent development of severe COVID-19 infection in a young and an unvaccinated cohort. Methods: COVID-19 infection was diagnosed in 572 young patients with a positive reverse-transcriptase- polymerase- chain- reaction assay performed on a standard naso-pharyngeal swab. Demographic and medical data were obtained at the time of the diagnosis, and patients were followed until recovery or death. Variables studies included age, sex, ethnicity, race, smoking status, alcohol status, hypertension, diabetes, asthma/COPD, heart dissease, immunosuppressive therapy, and obesity defined as a Body Mass Index = or > 30 Kg/m2. Subjects who developed decompensated hypoxia, associated with clinical manifestations and then hospitalized, were considered to have severe disease. Results: The cohort was limited to patients 18 to 40 yrs old,and consisted of 51.9% women. Forty three percent were white non-Hispanic or Latino, while 30 1% were black or African American, and 7% Asian. The mean age was 29.3 (SD +/-5.9) yrs, and mean BMI was 28.7 (+/-7.1) kg/m2. In a multivariable model patients with Asthma and Obesity had a significantly higher likelihood of developing severe Covid-19 infection and were both significant predictors of severe Covid-19 infection (HR = 3.25;95% CI = 1.4, 7.40;P < .005), and (HR = 2.1;95% CI = 1.3, 3.5;P < .005) respectively. Other factors including Age did not predict severe Covid-19 infection in this cohort. Conclusions: In patients younger than 40 years old, Obesity and Asthma predict the subsequent development of severe Covid-19 infection after diagnosis. This increased risk is regardless of age.