Overweight/obesity as the potentially most important lifestyle factor associated with signs of pneumonia in COVID-19

Abstract

Objective The occurrence of pneumonia separates severe cases of COVID-19 from the majority of cases with mild disease. However, the factors determining whether or not pneumonia develops remain to be fully uncovered. We therefore explored the associations of several lifestyle factors with signs of pneumonia in COVID-19. Methods Between May and July 2020, we conducted an online survey of adults in Germany who had recently gone through COVID-19, predominantly as outpatients (n=201). Of these, 165 had a PCR-based diagnosis and 36 had a retrospective diagnosis by antibody testing. The survey covered demographic information, eight lifestyle factors, comorbidities and medication use. We defined the main outcome as the presence vs. the absence of signs of pneumonia, represented by dyspnea, the requirement for oxygen therapy or intubation. Results Signs of pneumonia occurred in 39 of the 165 individuals with a PCR-based diagnosis of COVID-19 (23.6%). Among the lifestyle factors examined, only overweight/obesity associated with signs of pneumonia (odds ratio 2.68 (1.29 - 5.59) p=0.008). The observed association remained significant after multivariate adjustment, with BMI as a metric variable, and also after including the antibody-positive individuals into the analysis. Conclusions This exploratory study finds an association of overweight/obesity with signs of pneumonia in COVID-19. This finding suggests that a signal proportional to body fat mass, such as the hormone leptin, impairs the body's ability to clear SARS-CoV-2 before pneumonia develops. This hypothesis concurs with previous work and should be investigated further to possibly reduce the proportion of severe cases of COVID-19.

Initial Presenting Symptoms, Comorbidities and Severity of COVID-19 Patients Attending Hmawbi and Indine Treatment Centers During the Second Wave of Epidemic in Myanmar: a Cross-sectional Study

“…In this study, the sex distribution was not too different and it was in line with the studies done in China [19,29]. The recent study reported that (14.8%) of patients were the older age and it seemed to be consistent with the nding obtained in the China study (12.3%) [19] and lower than the studies conducted in the USA (28.3%) [30] and Germany (26.7%) [31]. More than one-fourth of the patients (26.2%) were overweight or obese in this study and this result was lower than the ndings of studies done in Thailand (32.9%) [32], Germany (38.2%) [31], and China (47.5%) [33].…”

“…Over 2012 to 2017, most of the admitted patients with NCDs were middle and older aged population with the median and interquartile range of 39 years and (51.6%) of those were males [38]. In the current study, the most common comorbidities were hypertension and diabetes mellitus and these results supported the ndings of the earlier studies conducted in hospitalized COVID-19 patients [19,30,31,34,36].…”

“…The recent study reported that (14.8%) of patients were the older age and it seemed to be consistent with the nding obtained in the China study (12.3%) [19] and lower than the studies conducted in the USA (28.3%) [30] and Germany (26.7%) [31]. More than one-fourth of the patients (26.2%) were overweight or obese in this study and this result was lower than the ndings of studies done in Thailand (32.9%) [32], Germany (38.2%) [31], and China (47.5%) [33]. The reason for these variations might be due to the difference in the socio-economic and geographical nature of the study area, variation in sample size, and distinction in lifestyle factors.…”

Immuno-fibrotic drivers of impaired lung function in post-acute sequelae of SARS-CoV-2 infection (PASC)

“…Leptin is a hormone secreted by adipocytes in proportion to obesity, a risk factor for severe acute COVID-19 (20), and may contributes to immune dysregulation during acute COVID-19 (21, 22). In our patient population with post-COVID-19 syndrome, we found leptin was inversely related to FVC, however, it is not clear if this simply reflects underlying obesity, a known cause for reduced FVC, or if it represents ongoing immune dysregulation (or both), and requires further study.…”

COVID-19-related symptoms 6 months after the infection - Update on a prospective cohort study in Germany

“…This survey was part of the ongoing, prospective, online cohort study Life&Covid that is being conducted in Germany since May 2020. The study design has been described previously (6). In brief, the study mainly aimed at investigating the influence of lifestyle factors on the course of acute COVID-19.…”