Obesity Is a Risk Factor for Greater COVID-19 Severity

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has attracted increasing worldwide attention (1). Obesity commonly aggravates the severity of respiratory diseases, but it is currently not known whether obese patients are also more likely to have greater COVID-19 severity of illness. We investigated the association between obesity and COVID-19 severity of illness among patients with laboratory-confirmed SARS-CoV-2 infection.We enrolled adult patients with COVID-19 from three hospitals in China between 17 January 2020 and 11 February 2020. Seventy-five patients were diagnosed as obese (i.e., case subjects). We randomly matched each case subject with one control subject (nonobese) by sex (1:1) and age (±5 years). The cohort thus comprised 150 patients with COVID-19. The study protocol was approved by local ethics committees of the three hospitals. The requirement for written informed consent was waived due to the retrospective and anonymous nature of the study.COVID-19 was diagnosed as a positive result by high-throughput sequencing or real-time reverse transcriptase PCR assay of oropharyngeal swab specimens. COVID-19 severity of illness was assessed during hospitalization and classified into four clinical subtypes (i.e., mild, moderate, severe, or critically ill) based on management guidelines (2). Obesity was defined as BMI ≥25 kg/m2 in this Asian population. Diabetes was determined as either history of diagnosed diabetes, …