Severely obese patients four times as likely to die from COVID-19

Researchers from Kaiser Permanente have identified a “striking association” between a person’s BMI and their risk of death from COVID-19, sharing their findings in Annals of Internal Medicine.

“Approximately 42.4% of the U.S. adult population is obese, and 9.2% is severely obese,” wrote lead author Sara Y. Tartof, PhD, MPH, Kaiser Permanente Southern California in Pasadena, and colleagues. “The Centers for Disease Control and Prevention lists severe obesity at any age as a high-risk condition for COVID-19. Given the high prevalence of obesity, the potential effect of COVID-19 in the U.S. population is tremendous.”

To learn more about the relationship between obesity and COVID-19, the team tracked data from more than 6,000 patients diagnosed with the virus from Feb. 13 to May 2, 2020. Overall, even after making certain adjustments for comorbidities, patients with a BMI of 40 to 44 kg/m2 had a relative risk of death from COVID-19 of 2.48. The relative risk for patients with a BMI greater than 45 kg/m2, meanwhile, was 4.18. The risk was also greater when the patient was male or 60 years old or younger. No independent association was observed for Black or Hispanic patients compared to white patients.

“Our finding that severe obesity, particularly among younger patients, eclipses the mortality risk posed by other obesity-related conditions, such as history of myocardial infarction, diabetes, hypertension, or hyperlipidemia, suggests a significant pathophysiologic link between excess adiposity and severe COVID-19 illness,” the authors wrote. “Obesity is not only an expansion of subcutaneous adipose tissue but is also associated with increased ectopic fat, including visceral, perivascular, and epicardial adipose tissue.”

The full analysis is available here.