Impact of body composition on COVID-19 susceptibility and severity: A two-sample multivariable Mendelian randomization study

Freuer, Dennis; Linseisen, Jakob; Meisinger, Christa

doi:10.1016/j.metabol.2021.154732

Cited by 68 publications

(72 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, both BMI and waist circumference were associated with testing positive for COVID-19 in a dose-response fashion [ 30 ]. However, another study using a two-sample multivariable Mendelian randomization failed to show the impact of body composition (waist circumference, trunk fat ratio) on COVID-19 susceptibility and severity; only BMI was significant [ 31 ]. Our study has a limitation in that it did not include body composition.…”

Section: Discussionmentioning

confidence: 99%

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

Kang

Kong

2021

PLoS ONE

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Kang

Kong

2021

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…However, gut dysbiosis by various factors has deleterious effects on host health, including the gastrointestinal tract [26] and immune system [27], and metabolic diseases [28]. The F/B ratio is known as a hallmark of obesity, and, interestingly, two recent studies have reported strong evidence for a causal impact of obesity on the susceptibility and severity of COVID-19 [29,30]. However, recent studies have reported no association between the F/B ratio and obesity [31].…”

Section: Discussionmentioning

confidence: 99%

Reversion of Gut Microbiota during the Recovery Phase in Patients with Asymptomatic or Mild COVID-19: Longitudinal Study

et al. 2021

View full text Add to dashboard Cite

Patients with COVID-19 have been reported to experience gastrointestinal symptoms as well as respiratory symptoms, but the effects of COVID-19 on the gut microbiota are poorly understood. We explored gut microbiome profiles associated with the respiratory infection of SARS-CoV-2 during the recovery phase in patients with asymptomatic or mild COVID-19. A longitudinal analysis was performed using the same patients to determine whether the gut microbiota changed after recovery from COVID-19. We applied 16S rRNA amplicon sequencing to analyze two paired fecal samples from 12 patients with asymptomatic or mild COVID-19. Fecal samples were selected at two time points: during SARS-CoV-2 infection (infected state) and after negative conversion of the viral RNA (recovered state). We also compared the microbiome data with those from 36 healthy controls. Microbial evenness of the recovered state was significantly increased compared with the infected state. SARS-CoV-2 infection induced the depletion of Bacteroidetes, while an abundance was observed with a tendency to rapidly reverse in the recovered state. The Firmicutes/Bacteroidetes ratio in the infected state was markedly higher than that in the recovered state. Gut dysbiosis was observed after infection even in patients with asymptomatic or mild COVID-19, while the composition of the gut microbiota was recovered after negative conversion of SARS-CoV-2 RNA. Modifying intestinal microbes in response to COVID-19 might be a useful therapeutic alternative.

show abstract

“…The association of obesity-related traits with COVID-19 outcomes has been confirmed by multiple investigations, also including MR analyses that showed putative causal effects of BMI [9,10,11,41,42], WC [9,10], and trunk fat ratio [9]. Some of these previous investigations also have included MVMR analyses that highlighted how the effect of these traits on COVID-19 is independent of several cardiometabolic traits and other known risk factors [43]. However, to our knowledge, no study evaluated whether the effect of obesity-related traits on COVID-19 outcomes is independent of SES.…”

Section: Discussionmentioning

confidence: 87%

“…We estimated the putative causal effect of anthropometric traits on COVID-19 phenotypes using a two-sample MR approach. Leveraging information from genome-wide association statistics, we can estimate the putative causal effect of the exposure on the outcome, which represents the sum of all possible paths from the exposure on the outcome [9,34]. This analysis was conducted using the R package TwoSampleMR [35].…”

Section: Methodsmentioning

confidence: 99%

“…Obesity appears to be one of the main factors associated with severe manifestations of COVID-19 [5-8]. Leveraging genetic information, few studies conducted causal inference analyses, showing that BMI and other body measure traits have a putative causal effect on severe and critical COVID-19 illness [9-11]. However, to our knowledge, no investigation was conducted to verify whether the effect of body composition on COVID-19 outcomes was mediated or moderated by other factors.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of obesity-related traits on COVID-19 severe respiratory symptoms is mediated by socioeconomic status: a multivariable Mendelian randomization study

Cabrera‐Mendoza

Wendt

Pathak

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Obesity has been associated with more severe clinical manifestations of coronavirus disease 2019 (COVID-19). However, this association can be affected by many correlates of these traits. Due to its large impact on human health, socioeconomic status (SES) could at least partially influence the association between obesity and COVID-19 severity. To estimate the independent effect of traits related to body size and SES on the clinical manifestations of COVID-19, we conducted a Mendelian randomization (MR) study analyzing the effect of obesity-related anthropometric traits on COVID-19 outcomes. Methods Applying two-sample MR approaches, we evaluated the effects of body mass index (BMI), waist circumference (WC), hip circumference, (HIP) and waist-hip ratio (WHR) studied in up to 234,069 participants from the Genetic Investigation of ANthropometric Traits (GIANT) consortium with respect to three COVID-19 outcomes: severe respiratory COVID-19 (5,101 cases vs. 1,383,241 controls), hospitalized COVID-19 (9,986 cases vs. 1,877,672 controls), and COVID-19 infection (38,984 cases vs. 1,644,784 controls) obtained from the COVID-19 Host Genetics Initiative (HGI). Finally, to test the effect of SES using multivariable MR methods, we analyzed genetic data related to self-reported household income (HI) information from 286,301 UK Biobank (UKB) participants. Results BMI and WC were associated with severe respiratory COVID-19 (BMI: OR = 1.68 p = 0.0004; WC: OR = 1.72, p = 0.007) and COVID-19 hospitalization (BMI: OR= 1.62, p = 1.35e-06; WC: OR = 1.62, p = 0.0001). Also, HIP influenced hospitalized COVID-19 (OR = 1.31, p = 0.012) and COVID-19 infection (OR = 1.18, p = 0.002). Conversely, HI was associated with lower odds of severe respiratory COVID-19 (OR = 0.57, p = 0.011) and hospitalized COVID-19 (OR = 0.71, p = 0.045). Testing these effects in multivariable MR models, we observed that the effect of these obesity-related anthropometric traits on COVID-19 outcomes is not independent of SES effect assessed as HI. Conclusions Our findings indicate that low SES is a contributor to the observed association between body size and COVID-19 outcomes.

show abstract

Impact of body composition on COVID-19 susceptibility and severity: A two-sample multivariable Mendelian randomization study

Cited by 68 publications

References 44 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

Reversion of Gut Microbiota during the Recovery Phase in Patients with Asymptomatic or Mild COVID-19: Longitudinal Study

The effect of obesity-related traits on COVID-19 severe respiratory symptoms is mediated by socioeconomic status: a multivariable Mendelian randomization study

Contact Info

Product

Resources

About