Diabesity Associates with Poor COVID-19 Outcomes among Hospitalized Patients

Abstract

Background: Although numerous studies have investigated obesity's negative effect on coronavirus disease 2019 outcomes, only a limited number focused on this association in diabetic patients. In this study, we analyzed the association between obesity and COVID-19 outcome (death, intensive care unit [ICU] admission, mechanical ventilation needs, quick Sequential Organ Failure Assessment [qSOFA] score, and confusion, urea, respiratory rate, blood pressure [CURB-65] scores) for hospitalized diabetic patients. Methods:In this prospective hospital-based registry of patients with COVID-19 in East Azerbaijan, Iran, 368 consecutive diabetic patients with COVID-19 were followed from admission until discharge or death. Self-reported weight and height were used to calculate body mass index (kg/m 2 ) upon admission. Our primary endpoint was analyzing obesity and COVID-19 mortality association. Assessing the associations among obesity and disease severity, ICU admission, and mechanical ventilation was our secondary endpoint. Results:We analyzed data from 317 patients and found no significant difference between obese and non-obese patients regarding frequency of death, invasive mechanical ventilation, ICU admission, CURB-65, or qSOFA scores (P>0.05). After adjusting for confounding factors, obese diabetic COVID-19 patients were 2.72 times more likely to die than non-obese patients. Moreover, ventilator dependence (adjusted odds ratio [aOR], 1.87; 95% confidence interval [CI], 1.03-4.76) and ICU admission (aOR, 2.41; 95% CI, 1.11-5.68) odds were significantly higher for obese patients than non-obese patients. Conclusion:The results of the present study indicated that obesity worsens health outcomes for diabetic COVID-19 patients.

Determinants of mortality among COVID-19 patients with diabetes mellitus in Addis Ababa, Ethiopia, 2022: An unmatched case-control study

“…Furthermore, obese patients (BMI≥30) were 7.78 times more likely to die compared to their counterparts [(AOR=7.78; 95% CI: 4.05, 14.90), p<0.001]. Earlier studies conducted on risk factors of mortality among COVID-19 patients supported this finding (7, 9, 25, 26). The pathologic link between mortality of diabetes COVID-19 patients and obesity can be multifactorial.…”

“…The study finding also revealed that diabetic patients who were admitted with mild and moderate COVID- (7,9,25,26). The pathologic link between mortality of diabetes COVID-19 patients and obesity can be multifactorial.…”

COVID-19 and diabetes: What do we know so far?

“…If the patients show chronic infection, the incidence of nosocomial infection increases and leads to mortality of T2DM which might be increased by decreased immunity of T2DM. 41…”

“…If the patients show chronic infection, the incidence of nosocomial infection increases and leads to mortality of T2DM which might be increased by decreased immunity of T2DM. 41 COVID-19 has the highest impact on the first-line immune defense in people with diabetes compared to the non-diabetic population. 25,42 People with diabetes are in pro-inflammatory state which triggers the cytokine response, leading to an increase in IL-6 and CRP levels in the blood.…”

Letter: Diabesity Associates with Poor COVID-19 Outcomes among Hospitalized Patients (J Obes Metab Syndr 2021;30:149-54)

“…Nikniaz et al 3 reported useful findings in a paper entitled “Diabesity associates with poor COVID-19 outcomes among hospitalized patients,” which was based on their prospective hospital-based registry of COVID-19 patients in East Azerbaijan, the Iranian province with the highest prevalence of obesity (over 26.3%). 4 This study analyzed data from subjects who were diagnosed with diabetes prior to COVID-19.…”