March 9, 2021 – Officials have linked overweight or obesity to a higher risk of more serious COVID-19. A CDC report this week adds numbers and some nuances to the association.
Data from nearly 150,000 North American adults hospitalized with COVID-19 across the country indicate that the risk of more serious illnesses increases along with the body mass index (BMI). The risk of hospitalization for COVID-19 and death associated with obesity was particularly high among people under the age of 65.
“As doctors develop treatment plans for patients with COVID-19, they must consider the risk of serious outcomes in patients with a higher BMI, especially for those with severe obesity,” the researchers note. They add that their findings suggest that “progressive intensive management of COVID-19 may be necessary for patients with more severe obesity”.
People with COVID-19 near the border between a healthy BMI and overweight – from 23.7 kg / mtwo at 25.9 kg / mtwo – presented the lowest risk of severe COVID symptoms.
The study was published online at Weekly morbidity and mortality report.
Greater need for intensive care
The risk of admission to the ICU was particularly associated with severe obesity. For example, those with a BMI in the range of 40 to 44.9 kg / mtwo category had an increased risk of 6%, which jumped to 16% higher among those with a BMI of 45 or more.
Compared to people with a healthy BMI, the need for mechanical ventilation was 12% more likely among overweight adults and a BMI of 25 to 29.2. The risk jumped to 108% higher among those with more severe obesity, those with a BMI of 45 or more, reported leading CDC researcher Lyudmyla Kompaniyets, PhD, and colleagues.
In addition, the risk of hospitalization and death increased with the level of obesity.
Interestingly, being underweight was also associated with a high risk of hospitalization for COVID-19. For example, people with a BMI below 18.5 had a 20% greater chance of admission compared to people in the healthy BMI range. Unknown underlying medical conditions or problems related to nutrition or immune function may be contributing factors, the researchers note.
High risk of death
The risk of death in adults with obesity ranged from 8% higher in the range of 30 to 34.9 to 61% higher for those with a BMI of 45.
Chronic inflammation or impaired lung function due to being overweight are possible reasons for a higher BMI to offer a higher risk, the researchers note.
The CDC researchers evaluated 148,494 adults from 238 hospitals participating in the PHD-SR database. As the study was limited to people hospitalized with COVID-19, the results may not apply to all adults with COVID-19.
Another potential limitation is that the researchers were unable to calculate BMI for all patients in the database because about 28% of participating hospitals did not report height and weight.