In a new study from Montefiore Medical Center, researchers found that obesity may be a stronger risk factor for death, severe pneumonia and the need for intubation in men than in women with COVID-19.
They that both moderate (BMI of 35/m2 or higher) and severe obesity (BMI of 40kg/m2 and higher) in men but only severe obesity in women (BMI of 40kg/m2 and higher) was linked to greater risk of developing severe disease, needing intubation and dying from COVID-19 in hospital.
Previous research showed that obesity is a risk factor for hospitalization, severe disease, and death in patients with COVID-19.
In the study, the team examined data obtained from electronic health records on 3530 patients with COVID-19, admitted to the inpatient medicine service or the intensive care unit at Montefiore Medical Center.
They found that patients with class II and III obesity had a higher likelihood of in-hospital mortality, especially when compared to patients in the normal weight group, and that this association was stronger as obesity class increased.
These patients were also more likely to develop severe pneumonia and to undergo intubation. In men, both class II (BMI 35-40kg/m2) and class III obesity (BMI higher than 40kg/m2) were associated with higher risk of death, while the same was only the case for women in obesity class III.
The team found that patients who died from COVID-19 had higher average levels of inflammation compared to survivors and that men had higher average levels of inflammation compared to women.
However, the authors found no clear association between inflammation markers and obesity, suggesting that while inflammation may play a role in severe disease and death from COVID-19, it may not be the mechanism that underlies the association between severe disease, death and obesity.
The authors speculate that obesity may increase the risk of worse outcomes in patients with COVID-19 via other mechanisms, such as affected lung function, increased work of breathing or a higher expression of the ACE2 receptor, which allows SARS-CoV-2 to enter cells, in adipose tissue.
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The study is published in the European Journal of Clinical Microbiology & Infectious Diseases. One author of the study is Arcelia Guerson-Gil.
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