Obesity Doubles Mortality in Patients Hospitalized for Severe Acute Respiratory Syndrome Coronavirus 2 in Paris Hospitals, France: A Cohort Study on 5,795 Patients

Abstract

Objective: Preliminary data from different cohorts of small sample size or with short follow-up indicate poorer prognosis in people with obesity compared with other patients. This study aims to precisely describe the strength of association between obesity in patients hospitalized with coronavirus disease 2019 (COVID-19) and mortality and to clarify the risk according to usual cardiometabolic risk factors in a large cohort. Methods: This is a prospective cohort study including 5,795 patients aged 18 to 79 years hospitalized from February 1 to April 30, 2020, in the Paris area, with confirmed infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Adjusted regression models were used to estimate the odds ratios (ORs) and 95% CIs for the mortality rate at 30 days across BMI classes, without and with imputation for missing BMI values. Results: Eight hundred ninety-one deaths had occurred at 30 days. Mortality was significantly raised in people with obesity, with the following ORs for BMI of 30 to 35 kg/m 2 , 35 to 40 kg/m 2 , and >40 kg/m 2 : 1.89 (95% CI: 1.45-2.47), 2.79 (95% CI: 1.95-3.97), and 2.55 (95% CI: 1.62-3.95), respectively (18.5-25 kg/m 2 was used as the reference class). This increase holds for all age classes. Conclusions: Obesity doubles mortality in patients hospitalized with COVID-19.

COVID-19 Associated Mortality and Cardiovascular Disease Outcomes Among U.S. Women Veterans

“…The current study con rmed older age, 4,7,22−24 obesity, [25][26][27] and prior CVD 4,14 and COPD 4,14 conditions as risk factors for mortality in COVID-19 disease. We observed only weak associations of prior CKD 4,14 with COVID-19 mortality risk.…”

Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning

“…Similar findings were reported in 5,795 patients with COVID-19, ages 18–79, hospitalized in Paris from February 1 to April 20, 2020, with a mean BMI of 29.3 and 27.2 for women and men, respectively. The odds ratios for relative risk of mortality at 30 days for SARS-CoV-2-infected subjects with a BMI of 25–29.9, 30–35, 35–40, and >40 were 1.41, 1.89, 2.79, and 2.55, respectively, even after correction for age, sex, and co-morbidities ( Czernichow et al., 2020 ). Notably, the relative risk of mortality for people with obesity increased progressively in older individuals.…”

Obesity and COVID‐19: A jigsaw puzzle with still missing pieces

“…Selected data on obesity and outcome are shown in Table 1. [17][18][19][20][21][22][23] In western countries, although data from Italy have confirmed earlier Chinese reports, 24 a French study showed that patients with BMI > 35 kg/m 2 were at significantly higher risk for the requirement of intensive mechanical ventilation compared to normal-weight individuals (with BMI lower than 25 kg/m 2 ), even after adjusting for age, diabetes and hypertension. 25 These results were later replicated in a different hospital in France 26 and have generated more interest in the association between adipose tissue excess and disease pathophysiology.…”