March 9, 2021 – Officials previously linked obesity or obesity to a greater risk for worse COVID-19. A report this week from the CDC adds figures and some nuances to the association.
Data from nearly 150,000 U.S. adults hospitalized with COVID-19 nationwide indicate that the risk of more serious diseases increases along with the body mass index (BMI). The risk of COVID-19-related hospitalization and obesity-related deaths was particularly high among people younger than 65.
“As clinicians develop care plans for COVID-19 patients, they should consider the risk of serious outcomes in patients with higher BMIs, especially for those with severe obesity,” the researchers note. They add their findings suggest that ‘progressive intensive management of COVID-19 may be necessary for patients with worse obesity.’
People with COVID-19 near the border between a healthy and overweight BMI – from 23.7 kg / m2 up to 25.9 kg / m2 – has the lowest risk of severe COVID symptoms.
The study was published online in Weekly report on diseases and deaths.
Greater need for critical care
The risk of admission to ICU is particularly related to severe obesity. For example, those with a BMI in the 40 to 44.9 kg / m2 category had an increased risk of 6%, rising to 16% higher among those with a BMI of 45 or higher.
Compared to people with a healthy BMI, the need for mechanical ventilation was 12% more likely among overweight adults with a BMI of 25 to 29.2. The risks jumped to 108% greater among those with the most severe obesity.
In addition, the risks of hospitalization and death increased along with the level of obesity.
Interestingly, underweight is also associated with increased risk for COVID-19 hospitalization. For example, people with a BMI of less than 18.5 have 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 say.
Increased risk of dying
The risk of death in adults with obesity ranged from 8% higher in the 30 to 34.9 range to 61% higher for those with a BMI of 45.
Chronic inflammation or impaired lung function due to being overweight are possible reasons why higher BMI poses a greater risk, the researchers say.
The CDC researchers evaluated 148,494 adults from 238 hospitals that participated in the PHD-SR database. Because the study was limited to people hospitalized with COVID-19, the findings may not apply to all adults with COVID-19.
Another possible limitation is that researchers could not calculate the BMI for all patients in the database because about 28% of the participating hospitals did not report height and weight.