Body Mass Index and Prognosis of COVID-19 Infection. A Systematic Review

Peres, Karina Colombera; Riera, Rachel; Martimbianco, Ana Luiza Cabrera; Ward, Laura Sterian; Cunha, Lucas Leite

doi:10.3389/fendo.2020.00562

Cited by 32 publications

(61 citation statements)

References 33 publications

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“…To date, there is scarcity of information regarding the obesity survival paradox or underweight risk associated with the outcomes of COVID-19. A systematic review found that the association of obesity with poor clinical presentation and the need for hospitalization due to COVID-19 was consistent, but the association of obesity mortality was not [ 17 ]. Hence, in this study, we aimed at evaluating the relationship between BMI and severe COVID-19, especially fatality.…”

Section: Introductionmentioning

confidence: 99%

Body mass index and severity/fatality from coronavirus disease 2019: A nationwide epidemiological study in Korea

Kang

Kong

2021

PLoS ONE

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Objective Obesity has been reported as a risk factor for severe coronavirus disease 2019 (COVID-19) in recent studies. However, the relationship between body mass index (BMI) and COVID-19 severity and fatality are unclear. Research design and methods This study included 4,141 COVID-19 patients who were released from isolation or had died as of April 30, 2020. This nationwide data was provided by the Korean Centers for Disease Control and Prevention Agency. BMI was categorized as follows; < 18.5 kg/m2, 18.5–22.9 kg/m2, 23.0–24.9 kg/m2, 25.0–29.9 kg/m2, and ≥ 30 kg/m2. We defined a fatal illness if the patient had died. Results Among participants, those with a BMI of 18.5–22.9 kg/m2 were the most common (42.0%), followed by 25.0–29.9 kg/m2 (24.4%), 23.0–24.9 kg/m2 (24.3%), ≥ 30 kg/m2 (4.7%), and < 18.5 kg/m2 (4.6%). In addition, 1,654 (41.2%) were men and 3.04% were fatalities. Multivariable analysis showed that age, male sex, BMI < 18.5 kg/m2, BMI ≥ 25 kg/m2, diabetes mellitus, chronic kidney disease, cancer, and dementia were independent risk factors for fatal illness. In particular, BMI < 18.5 kg/m2 (odds ratio [OR] 3.97, 95% CI 1.77–8.92), 25.0–29.9 kg/m2 (2.43, 1.32–4.47), and ≥ 30 kg/m2 (4.32, 1.37–13.61) were found to have higher ORs than the BMI of 23.0–24.9 kg/m2 (reference). There was no significant difference between those with a BMI of 18.5–22.9 kg/m2 (1.59, 0.88–2.89) and 23.0–24.9 kg/m2. Conclusions This study demonstrated a non-linear (U-shaped) relationship between BMI and fatal illness. Subjects with a BMI of < 18.5 kg/m2 and those with a BMI ≥ 25 kg/m2 had a high risk of fatal illness. Maintaining a healthy weight is important not only to prevent chronic cardiometabolic diseases, but also to improve the outcome of COVID-19.

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Section: Introductionmentioning

confidence: 99%

Body mass index and severity/fatality from coronavirus disease 2019: A nationwide epidemiological study in Korea

Kang

Kong

2021

PLoS ONE

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“…Importantly, we found no effect of race or ethnicity with time to viral RNA clearance after adjustment for other demographic and comorbidities. Obesity is associated with testing positive for SARS-CoV-2, with severity of COVID-19, and with COVID-19 mortality [33][34][35][36]. Dysregulated immunity is observed in severe COVID-19, aging, and obesity, and it may be the unmeasured key correlate of viral RNA shedding duration.…”

Section: Discussionmentioning

confidence: 99%

Delayed rise of oral fluid antibodies, elevated BMI, and absence of early fever correlate with longer time to SARS-CoV-2 RNA clearance in an longitudinally sampled cohort of COVID-19 outpatients

Antar

Pisanic

et al. 2021

Preprint

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Background Viral and immune kinetics in mild to moderate COVID-19 are understudied because of challenges inherent in longitudinal sampling of people who are infectious to others, feeling ill, yet are not hospitalized. In particular, sustained molecular detection of SARS-CoV-2 RNA in the upper respiratory tract (URT) in mild to moderate COVID-19 is common and confounds surveillance efforts in the community. We sought to identify host and immune determinants of prolonged SARS-CoV-2 RNA detection via longitudinal viral RNA, virus culture, and plasma and oral fluid antibody sampling in a prospective observational cohort study of adult outpatients with COVID-19. Methods and Findings Samples from 95 non-hospitalized participants ≥ 30 years old with recent COVID-19 diagnosis and known symptom onset date were analyzed. Participants self-collected mid-turbinate nasal, oropharyngeal (OP), and gingival crevicular fluid (oral fluid) samples at home and in a research clinic a median of 6 times over 1-3 months. SARS-CoV-2 RT-PCR performed on 507 URT samples revealed a median time to viral RNA clearance of the URT of 33.5 days. Sixteen nasal-OP samples collected 2-11 days post-symptom onset were virus culture positive out of 183 RT-PCR positive samples tested. All participants but one with positive virus culture were negative for concomitant oral fluid anti-SARS-CoV-2 spike-receptor binding domain (S-RBD) antibodies. The kinetics of oral fluid anti-SARS-Cov-2 antibodies were measured using a multiplex immunoassay. The mean time to first detection of oral fluid anti-SARS-CoV-2 antibodies was 8-13 days post-symptom onset. Associations of symptoms, host demographics, comorbidities, and immune kinetics with time to SARS-CoV-2 RNA clearance were estimated using Cox proportional hazards models. A longer time to first detection of oral fluid anti-SARS-CoV-2 S antibodies was independently associated with a longer time to SARS-CoV-2 viral RNA clearance (aHR 0.96, 95% CI 0.92-0.99, p=0.020). BMI ≥ 25kg/m2 was also independently associated with a longer time to viral RNA clearance (aHR 0.37, 95% CI 0.18-0.78, p=0.009). Fever reported as one of first three COVID-19 symptoms was associated with shorter time to viral RNA clearance (aHR 2.06, 95% CI 1.02-4.18, p=0.044). Plasma titers of neutralizing antibodies, SARS-CoV-2 spike (S) antibodies, and S-receptor binding domain (S-RBD) antibodies were obtained at 1-4 months post-symptom onset. BMI was positively correlated with post-acute plasma SARS-CoV-2-specific neutralizing antibody titer and anti-S-RBD antibody titer. Conclusions In an intensively sampled cohort of 95 adult outpatients with COVID-19, we demonstrate that longer time to first detection of oral fluid SARS-CoV-2-specific antibodies, elevated BMI, and absence of early fever are independently associated with longer time to viral RNA clearance. This work provides insights into the host and immune factors most important for viral clearance in mild to moderate COVID-19.

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“…Obesity is a major societal and health problem, in western countries and beyond [ 1 , 2 , 3 ]. We recently saw how obesity and its complications as a co-morbidity factor [ 4 ] might threaten the health of many people in front of viral aggression [ 5 ], rendering this condition even more dangerous than “simply” those traditionally associated with overweight conditions, such as heart conditions and joint and bone fragilization, among many others. For about two decades, researchers have attempted to determine the role of several central systems in appetite control, reasoning that the smaller the food income, the smaller the weight gain, and thus the better the health condition will be.…”

Section: Introductionmentioning

confidence: 99%

MCH-R1 Antagonist GPS18169, a Pseudopeptide, Is a Peripheral Anti-Obesity Agent in Mice

Boutin

Jullian²,

Frankiewicz³

et al. 2021

Molecules

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Melanin-concentrating hormone (MCH) is a 19 amino acid long peptide found in the brain of animals, including fishes, batrachians, and mammals. MCH is implicated in appetite and/or energy homeostasis. Antagonists at its receptor (MCH-R1) could be major tools (or ultimately drugs) to understand the mechanism of MCH action and to fight the obesity syndrome that is a worldwide societal health problem. Ever since the deorphanisation of the MCH receptor, we cloned, expressed, and characterized the receptor MCH-R1 and started a vast medicinal chemistry program aiming at the discovery of such usable compounds. In the present final work, we describe GPS18169, a pseudopeptide antagonist at the MCH-R1 receptor with an affinity in the nanomolar range and a Ki for its antagonistic effect in the 20 picomolar range. Its metabolic stability is rather ameliorated compared to its initial parent compound, the antagonist S38151. We tested it in an in vivo experiment using high diet mice. GPS18169 was found to be active in limiting the accumulation of adipose tissues and, correlatively, we observed a normalization of the insulin level in the treated animals, while no change in food or water consumption was observed.

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Body Mass Index and Prognosis of COVID-19 Infection. A Systematic Review

Cited by 32 publications

References 33 publications

Body mass index and severity/fatality from coronavirus disease 2019: A nationwide epidemiological study in Korea

Body mass index and severity/fatality from coronavirus disease 2019: A nationwide epidemiological study in Korea

Delayed rise of oral fluid antibodies, elevated BMI, and absence of early fever correlate with longer time to SARS-CoV-2 RNA clearance in an longitudinally sampled cohort of COVID-19 outpatients

MCH-R1 Antagonist GPS18169, a Pseudopeptide, Is a Peripheral Anti-Obesity Agent in Mice

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