Obesity is a major risk factor for severe COVID-19 illness

Abstract

Introduction: Conditions including obesity, diabetes mellitus (DM), chronic kidney disease (CKD), heart disease, and chronic obstructive pulmonary disease (COPD) predispose individuals to severe illness from COVID-19. We estimated the prevalence of these risk factors in the United States population. Methods: Participants in the National Health and Nutrition Examination Survey (NHANES) 2011 to 2016 aged ≥20 years were included. Pregnant participants and those with missing relevant laboratory/examination/selfreported data were excluded. The prevalence of obesity, DM, CKD, heart disease, and COPD were calculated. Subgroups according to age (<50 and ≥50 years), sex, and ethnicity were compared. Data analysis was performed using the R statistical package “survey” (version 3.6.3). Results: Altogether 7744 NHANES participants (mean age 49.5 years; 49.4% male) were analysed. Obesity was the most common risk factor (41.0%) followed by DM and CKD. Whereas DM, CKD, heart disease, and COPD were more common in people aged ≥50 years, obesity was almost equally common in either age-group. Overall, the prevalence of ≥1 risk factor was 58.9% In people aged ≥50, 69.5% had one or more risk factors, compared with 47.9% in people aged <50 years. In the latter age-group, the prevalence of obesity was 38.9%, making it the leading risk factor. The prevalence of one or more risk factors was around 60% across people of different sex and ethnicity, except in Asians (39.5%), in whom both obesity and DM are the leading risk factors. Conclusion: More than half of adult Americans are at risk from severe COVID-19 illness. Obesity is the major risk factor. COVID-19 is a threat to people across all age-groups, sexes, and ethnicities. Individuals with increased risk should strictly follow social distancing and personal hygiene measures, as well as adopt lifestyle modifications for weight control. Acknowledgement: HL Li was a research intern under the Research Internship Scheme (RIS)