As covered in the preceding article, we now know from US data between March 1-30, 2020 that older adults and those with hypertension (high blood pressure), obesity, diabetes and CVD are at an increased risk of requiring hospitalization should they contract Covid-19, but a new study finds that so are young people with obesity.
A study released ahead of publication found that of the more than 3600 people who tested positive for Covid-19 in a large academic hospital in New York City, more than 20% had a BMI of 30-34 (Class I obesity) and more than 15% had a BMI > 35 (Class II obesity or higher). When stratified by age, researchers found significantly higher rates of hospital admission and the requirement for ICU care in patients <60 years of age with obesity.
Compared with patients with a BMI of < 30 (i.e. overweight but not obese), patients under 60 years of age with Class I obesity were;
- 2.0 times more likely to be admitted to Acute Care
- 1.8 times more likely to be admitted to intensive care
Compared with patients under the age of 60 years old with a BMI <30 (not obese), patients with a BMI of 35 and above (Class II obesity and higher) were;
- 2.2 times more likely of being admitted to Acute Care
- 3.6 times more likely to be admitted to intensive care
Among the 3600 patients who were subjects in this study, there was no significant difference in hospitalization rates and intensive care needs by BMI among people 60 years of age and older, which is consistent with findings reported in the preceding article which found that obesity was a significantly higher risk factor of hospitalization in those 18-49 years of age .
Note: As covered in the previous article, hypertension (i.e. high blood pressure) is a significant underlying condition to adults ⩾ 65 years of age hospitalized with Covid-19.
Patients with a BMI of ⩾30 in the current study represented 36% of all patients; which is fairly representative of the US population as a whole which is estimated to have an obesity rate of BMI ⩾30 of 40% [3,4]. Given that obesity rates of BMI ⩾30 in Canada  is ~ 33%, it is possible that need for hospitalization and acute or intensive care may be somewhat lower here (i.e. more reflective of the slightly lower obesity rates in Canada).
With a vaccine for COVID-19 a year or longer away, current efforts to reduce the risk of contracting the virus necessarily focus on physical and social distancing, personal hygiene including proper hand-washing techniques and avoiding touching one’s face, as well as wearing face coverings in public places. These are all very important, however those under the age of 60 years of can reduce the risk of getting serious complications or dying from complications from the virus by achieving, then maintaining a healthy body weight.
Reversing Obesity – easier said than done?
Most people know that achieving and maintaining a healthy body weight is important to lower the risk of getting type 2 diabetes, hypertension and cardiovascular disease. Since we are already eating most of our meals at home and with a covid-19 vaccine a year or more away, now is an ideal time to make the dietary changes needed to achieve a healthy body weight and lower our risks of requiring hospitalization should we get Covid-19. In fact, most people in the class I obesity (BMI > 30) category can make the dietary changes necessary to achieve a normal body weight within in a few months.
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- Garg S, Kim L, Whitaker M, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep. ePub: 8 April 2
- Lighter J, Phillips M, Hochman S et al, Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission, accepted manuscript, Clinical Infectious Diseases. doi: 10.1093/cid/ciaa415, https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa415/5818333
- Ogden, C.L., et al., Prevalence of Obesity Among Adults, by Household Income and Education – United States, 2011-2014. MMWR Morb Mortal Wkly Rep, 2017. 66(50):p. 1369-1373
- State of Obesity, Adult Obesity in the United States, https://stateofobesity.org/adult-obesity/
- Statistics Canada, Health at a Glance, Adjusting the scales: Obesity in the Canadian population after correcting for respondent bias, https://www150.statcan.gc.ca/n1/pub/82-624-x/2014001/article/11922-eng.htm
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