Higher Obesity Trends Among African Americans Are Associated with Increased Mortality in Infected COVID-19 Patients Within the City of Detroit

Asare, Smart; Sandio, Aubin; Opara, Ijeoma Nnodim; Riddle-Jones, Latonya; Palla, Mohan; Renny, Nkechi; Ayers, Eric

doi:10.1007/s42399-020-00385-y

Cited by 10 publications

(6 citation statements)

References 2 publications

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“…A retrospective analysis of 112 patients with COVID-19 showed that 88.2% of non-survivors had a BMI ⩾25 compared to 18.8% of survivors [75]. Asare et al showed that 733 of 1930 deaths from COVID-19 were contributed to obesity alone in patients without reported comorbid conditions such as hypertension and cardiovascular disease [76]. On the contrary, no difference in the mortality rates was found between those with obesity and the non-obesity arm [77].…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis of the association between obesity and COVID-19

Jiao

Lei

2020

Epidemiol. Infect.

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Owing to limited data, we conducted a meta-analysis to re-evaluate the relationship between obesity and coronavirus-2019 (COVID-19). Literature published between 1 January 2020 and 22 August 2020 was comprehensively analysed, and RevMan3.5 was used for data analysis. A total of 50 studies, including data on 18 260 378 patients, were available. Obesity was associated with a higher risk of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) infection (odds ratio (OR): 1.39, 95% confidence interval (CI) 1.25–1.54; P < 0.00001) and increased severity of COVID-19 (hospitalisation rate: OR: 2.45, 95% CI 1.78–3.39; P < 0.00001; severe cases: OR: 3.74, 95% CI 1.18–11.87; P: 0.02; need for intensive care unit admission: OR: 1.30, 95% CI 1.21–1.40; P < 0.00001; need for invasive mechanical ventilation: OR: 1.59, 95% CI 1.35–1.88; P < 0.00001 and mortality: OR: 1.65, 95% CI 1.21–2.25; P: 0.001). However, we found a non-linear association between BMI and the severity of COVID-19. In conclusion, we found that obesity could increase the risk of SARS-CoV2 infection and aggregate the severity of COVID-19. Further studies are needed to explore the possible mechanisms behind this association.

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Section: Discussionmentioning

confidence: 99%

A meta-analysis of the association between obesity and COVID-19

Jiao

Lei

2020

Epidemiol. Infect.

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“…Additionally, prior studies have shown higher rates of hospitalization among men and African Americans 7 , 8 . The higher prevalence of comorbidities among African-Americans may contribute to the disproportionate number of cases and mortality, with higher obesity trends alone among African-Americans having been associated with increased mortality in COVID-19 patients 19 . In our non-hospitalized COVID-19 patients, however, most were female (69.2%) and African Americans were not over-represented relative to the population demographics of the Atlanta metropolitan area (49.5% in study versus 51.8% city of Atlanta 20 ).…”

Section: Discussionmentioning

confidence: 99%

Non-hospitalized Adults with COVID-19 Differ Noticeably from Hospitalized Adults in Their Demographic, Clinical, and Social Characteristics

Bergquist

Partin

Roberts

et al. 2020

SN Compr. Clin. Med.

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The characteristics of patients with coronavirus disease 2019 (COVID-19) have primarily been described in hospitalized adults. Characterization of COVID-19 in ambulatory care is needed for a better understanding of its evolving epidemiology. Our aim is to provide a description of the demographics, comorbidities, clinical presentation, and social factors in confirmed SARS-CoV-2-positive non-hospitalized adults. We conducted a retrospective medical record review of 208 confirmed SARS-CoV-2-positive patients treated in a COVID-19 virtual outpatient management clinic established in an academic health system in Georgia. The mean age was 47.8 (range 21–88) and 69.2% were female. By race/ethnicity, 49.5% were non-Hispanic African American, 25.5% other/unknown, 22.6% non-Hispanic white, and 2.4% Hispanic. Nearly 70% had at least one preexisting medical condition. The most common presenting symptoms were cough (75.5%), loss of smell or taste (63%), headache (62%), and body aches (54.3%). Physician or advanced practice provider assessed symptom severity ranged from 51.9% mild, 30.3% moderate, and 1.4% severe. Only eight reported limitations to home care (3.8%), 55.3% had a caregiver available, and 93.3% reported initiating self-isolation. Care needs were met for 83.2%. Our results suggest the demographic and clinical characteristics of COVID-19 illness in non-hospitalized adults differ considerably from hospitalized patients and warrant greater awareness of risk among younger and healthier individuals and consideration of testing and recommending self-isolation for a wider spectrum of clinical symptoms by clinicians. Social factors may also influence the efficacy of preventive strategies and allocation of resources toward the SARS-CoV-2 pandemic.

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“…It has been widely assessed that obesity has an adverse effect on respiratory physiology both for mechanical factors and for impaired adipocyte-mediated immune function by increased levels of pro-inflammatory cytokines and by decreased anti-inflammatory adipokines. Majority of the observational and retrospective cohort studies on thousands of patients with COVID-19 report that obese subjects are at increased risk of severe disease and increased mortality due to COVID-19 ( Asare et al, 2020 ; Gazzaruso et al, 2020 ; Pettit et al, 2020 ; Guerson-Gil et al, 2021 ; Rapp et al, 2021 ). Since respiratory failure usually takes place at 8–12 days from the initial signs of infection, there would be a window of opportunity to intervene, for instance by downregulating the leptin production ( van der Voort et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection?

et al. 2021

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Leptin is a pleiotropic adipocytokine involved in several physiologic functions, with a known role in innate and adaptive immunity as well as in tissue homeostasis. Long- and short-isoforms of leptin receptors are widely expressed in many peripheral tissues and organs, such as the respiratory tract. Similar to leptin, microbiota affects the immune system and may interfere with lung health through the bidirectional crosstalk called the “gut-lung axis.” Obesity leads to impaired protective immunity and altered susceptibility to pulmonary infections, as those by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it is known that leptin and microbiota link metabolism and lung health, their role within the SARS-CoV2 coronavirus disease 2019 (COVID-19) deserves further investigations. This review aimed to summarize the available evidence about: (i) the role of leptin in immune modulation; (ii) the role of gut microbiota within the gut-lung axis in modulating leptin sensitivity; and (iii) the role of leptin in the pathophysiology of COVID-19.

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Higher Obesity Trends Among African Americans Are Associated with Increased Mortality in Infected COVID-19 Patients Within the City of Detroit

Cited by 10 publications

References 2 publications

A meta-analysis of the association between obesity and COVID-19

A meta-analysis of the association between obesity and COVID-19

Non-hospitalized Adults with COVID-19 Differ Noticeably from Hospitalized Adults in Their Demographic, Clinical, and Social Characteristics

Leptin in the Respiratory Tract: Is There a Role in SARS-CoV-2 Infection?

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