Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04–2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04–3.80; immunosuppression: HR = 5.06, 95% CI 2.26–11.41; hypertension: HR = 2.30, 95% CI 1.77–3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.

Domiciliary confinement of people is one of the main strategies to limit the impact of COVID-19. Lockdowns have led to changes in lifestyle, emotional health, and eating habits. We aimed to evaluate the association of differences in dietary behaviours and lifestyle with self-reported weight gain during the COVID-19 lockdown in Chile. In this cross-sectional analytical study, five previously validated surveys were condensed into a single 86-item online questionnaire. The survey was sent to 1000 potential participants of the university community; it was kept online for 28 days to be answered. Of the 639 respondents, the mean self-reported weight gain during confinement was 1.99 kg (standard deviation [SE]: 0.17) and 0.7 (SE: 0.06) units of body mass index (BMI) (both p < 0.001) and the median difference in body weight during lockdown was 3.3% (interquartile range [IQR]: 0.0–6.7). The differences of intake of most food groups before and during lockdown were associated with greater self-reported weight, BMI and percentage weight gain. Differences in lifestyle (odds ratio [OR] = 14.21, 95% confidence interval [95%CI]: 2.35–85.82) worsening eating habits (OR = 3.43, 95%CI: 2.31–5.09), and more consumption of sweet or filled cookies and cakes during lockdown (OR = 2.11, 95%CI: 1.42–3.13) were associated with self-reported weight gain. In conclusion, different dietary behaviours (mainly consumption of industrialized foods) during lockdown, as well as quality of life deterioration were the main factors associated with self-reported weight gain during lockdown.

Domiciliary confinement of people is one of the main strategies to limit the impact of COVID-19. However, lockdowns have led to changes in lifestyle, emotional health, and eating habits. We aimed to evaluate the effect of changes in dietary behaviours and lifestyle on weight gain during the COVID-19 lockdown in Chile. In this crosssectional analytical study, five surveys were condensed into a single 86-item online questionnaire comprising general and sociodemographic history, eating habits before and during confinement, measurement of the emotional influence on eating behaviour, lifestyle before and during confinement, and food safety. The survey was previously validated by experts in nutrition and public health and subsequently sent to 1000 potential participants of the university community; it was kept online for 28 days to be answered. Of the 639 respondents, the mean weight gain during confinement was 1.99 kg and 0.7 units of body mass index (BMI). The increases in dietary intake of most food groups were associated with greater weight gain, BMI and percentage weight gain. Lifestyle deterioration, worsening eating habits, and increased consumption of sweet or filled cookies and cakes were the main risk factors associated with weight gain. Only 2% of BMI changes were explained by the interaction between lifestyle changes and emotional influence, whereas 64% of changes were due to a deterioration in lifestyle during confinement. In conclusion, changes in dietary behaviours (mainly increased consumption of ultra-processed foods), as well as quality of life deterioration were the main factors associated with weight gain during lockdown.

We aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19. We performed a retrospective observational analysis in a national cohort of 71,103 patients. Multivariate logistic regression models were applied to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia, and admission to an intensive care unit, conferred by obesity and other comorbidities From February 24 to April 26, 2020, 71,103 patients were evaluated for suspected COVID-19; 15,529 (21.8%) had a positive test for SARS-CoV-2; 46,960 (66.1%), negative, and 8,614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (HR=2.37, 95%CI:1.96-2.86), but not in negative and pending-result patients. In conclusion, obesity is a strong independent risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.