Obesity and COVID-19 in Adult Patients With Diabetes

Obesity has caused wide concerns due to its high prevalence in severe COVID-19 cases. Co-existence of diabetes and obesity could cause an even higher risk of severe outcomes due to immunity dysfunction. We conducted a retrospective study in 1637 adult patients who were admitted into an acute hospital in Wuhan, China. Propensity score matched logistic regression was used to estimate the risks of severe pneumonia and requiring in-hospital oxygen therapy associated with obesity. After adjustment for age, sex and comorbidities, obesity was significantly associated with higher odds of severe pneumonia (odd ratio [OR] 1.47 [95% CI 1.15-1.88], P=0.002) and oxygen therapy (OR 1.40 [95% CI 1.10-1.79], P=0.007). Higher ORs of severe pneumonia due to obesity were observed in men, older adults and those with diabetes. Among patients with diabetes, overweight increased the odds of requiring in-hospital oxygen therapy by 0.68 times (P=0.014) and obesity increased the odds by 1.06 times (P=0.028). A linear dose-response curve between BMI and severe outcomes was observed in all patients, whereas a U-shaped curve in those with diabetes. Our findings provide important evidence to support obesity as an independent risk factor for severe outcomes of COVID-19 infection in the early phase of the ongoing pandemic.