Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study
Authors' conclusion
Obesity is associated with worse outcomes in COVID-19, notably in younger participants and in the pre-Omicron era. Inflammation, as measured by suPAR, is a significant mediator of the association between obesity and COVID-19 outcomes.
Study context
- Population
- Adults hospitalized specifically for COVID-19, 1 Feb 2020–19 Oct 2022, 10 hospitals in the United States and Europe; mean age 59.3, 45.6% male, 21.8% body mass index (BMI) ≥ 35
- Participants
- 4,644 adults
- Exposure
- BMI >40 vs nonobese
- BMI > 40n = 485
- Nonobesen = 2,358reference
- Outcome
- Composite of:
- Death
- Need for mechanical ventilation
- Renal replacement therapy
Methodological detailsmulticenter, observational
- Multicenter
- Observational
Main finding
As reported in the abstract
Composite of:
- Death
- Mechanical ventilation
- Renal replacement therapy
- BMI > 40 vs Nonobese: 95% CI 1.21–1.98
- Multivariable analysis
Observational data: associations, not effects.
Further findings
Mediation by inflammatory biomarkers
- In multiple mediation analysis, only soluble urokinase plasminogen activator receptor (suPAR) remained a significant mediator between BMI and composite outcome
Subgroups by age and variant
- Associations amplified in participants <65 years and with pre-Omicron variants
Original publication
Obesity, Inflammation, and Clinical Outcomes in COVID-19: A Multicenter Prospective Cohort Study. J Clin Endocrinol Metab. Published 18 April 2024. doi:10.
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