Obesity and its Implications for COVID‐19 Mortality

Obesity-related conditions seem to worsen the effect of COVID-19

Indeed, the Centers for Disease Control and Prevention (CDC) reported that people with heart disease and diabetes are at higher risk of COVID-19 complications.

A recent Journal of the American Medical Association viewpoint regarding fatalities in Italy associated with the new coronavirus (COVID‐19) pandemic failed to mention obesity as one of the preexisting diseases associated with death. It seems likely that the increased prevalence of obesity in older adults in Italy compared with China may account for the differences in mortality between the two countries. Furthermore, the rising prevalence of obesity in the United States and prior experience of the impact of obesity on mortality from H1N1 influenza should increase the sensitivity of clinicians caring for patients with obesity and COVID‐19 to the need for aggressive treatment of such patients.

Between April 2009 and January 2010, the Centers for Disease Control and Prevention estimated that 41 to 84 million people were infected with the H1N1 influenza virus and that between 180,000 and 370,000 infected patients were hospitalized, with 8,000 to 17,000 deaths. Several reports from around the world identified obesity and severe obesity as risk factors for hospitalization and mechanical ventilation. For example, in California between April and August 2009, 1,088 patients with H1N1 influenza either were hospitalized or died. Of 268 patients ≥ 20 years old in whom BMI was calculated, 58% had obesity (BMI ≥ 30), and 67% of those had severe obesity BMI ≥ 40. Sixty‐six percent of those with obesity also had underlying diseases, such as chronic lung disease, including asthma, cardiac problems, or diabetes. Among hospitalized patients in New Mexico in 2009, 46% had obesity, and 56% of those requiring mechanical ventilation had severe obesity. Rates of H1N1 hospitalizations were significantly greater among American Indians, African Americans, and Hispanics than among non‐Hispanic whites, possibly reflecting the increased prevalence of obesity in those populations. The distribution of obesity among hospitalized patients in California and New Mexico exceeded the 35% prevalence of obesity in US adults in 2009 to 2010.

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Endocrinology and Metabolism: Open Access
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