Diabetes and Overweight/Obesity Are Independent, Nonadditive Risk Factors for In-Hospital Severity of COVID-19: An International, Multicenter Retrospective Meta-analysis | Zendy

Danielle K. Longmore | Zendy; Jessica E. Miller | Zendy; Siroon Bekkering | Zendy; Christoph Saner | Zendy; Edin Mifsud | Zendy; Yanshan Zhu | Zendy; Richard Saffery | Zendy; Alistair Nichol | Zendy; Graham A. Colditz | Zendy; Kirsty R. Short | Zendy; David Burgner | Zendy; F. Anfasa | Zendy; Thomas Benfield | Zendy; Marc J. T. Blaauw | Zendy; Leandra J M Boonman-de Winter | Zendy; Antonio Brucato | Zendy; Eirik Alnes Buanes | Zendy; Erlina Burhan | Zendy; Elisa Calabrò | Zendy; Alessandro Ceschi | Zendy; Rekai Lionel Chinhoyi | Zendy; H.F.E.W. Cuijpers | Zendy; A. Dofferhoff | Zendy; X. Fang | Zendy; Lucie Favre | Zendy; Paolo Ferrari | Zendy; Tatiana Fomina | Zendy; Jennifer A. Fulcher | Zendy; Andrea Giacomelli | Zendy; David GoodmanMeza | Zendy; Piyush Goyal | Zendy; Albert Groenendijk | Zendy; Jacobien J. Hoogerwerf | Zendy; S.B. Israelsen | Zendy; Mario Karolyi | Zendy; Angèle P. M. Kerckhoffs | Zendy; Ditte Marie Kirkegaard-Klitbo | Zendy; Sukamto Koesnoe | Zendy; Chao Luo | Zendy; David Chien Lye | Zendy; Ntobeko Ntusi | Zendy; Sean Wei Xiang Ong | Zendy; Letizia Oreni | Zendy; Hendri Pangestu | Zendy; Matthaios PapadimitriouOlivgeris | Zendy; Swandari Paramita | Zendy; Erich Pawelka | Zendy; Luca Persani | Zendy; Ceva Wicaksono Pitoyo | Zendy; Plataki | Zendy; M. Prasenohadi | Zendy; Ignatius Bima Prasetya | Zendy; Xiaorui Qu | Zendy; Mangala Rajan | Zendy; Joanna Bryan Ringel | Zendy; Monika M. Safford | Zendy; Totok Budi Santoso | Zendy; Davide Soranna | Zendy; T. Sprong | Zendy; C Stoll | Zendy; Amin Susanto | Zendy; Ari Fahrial Syam | Zendy; Camilla Torlasco | Zendy; Marjan van Apeldoorn | Zendy; Josephine van de Maat | Zendy; Karin Veerman | Zendy; Annelies Verbon | Zendy; Xiaoxiao Wen | Zendy; Marjan J. Westerman | Zendy; EvertJan Wils | Zendy; Yuanqing Xia | Zendy; B.E. Young | Zendy

Open Access

Diabetes and Overweight/Obesity Are Independent, Nonadditive Risk Factors for In-Hospital Severity of COVID-19: An International, Multicenter Retrospective Meta-analysis

Author(s) -

Danielle K. Longmore,

Jessica E. Miller,

Siroon Bekkering,

Christoph Saner,

Edin Mifsud,

Yanshan Zhu,

Richard Saffery,

Alistair Nichol,

Graham A. Colditz,

Kirsty R. Short,

David Burgner,

F. Anfasa,

Thomas Benfield,

Marc J. T. Blaauw,

Leandra J M Boonman-de Winter,

Antonio Brucato,

Eirik Alnes Buanes,

Erlina Burhan,

Elisa Calabrò,

Alessandro Ceschi,

Rekai Lionel Chinhoyi,

H.F.E.W. Cuijpers,

A. Dofferhoff,

X. Fang,

Lucie Favre,

Paolo Ferrari,

Tatiana Fomina,

Jennifer A. Fulcher,

Andrea Giacomelli,

David GoodmanMeza,

Piyush Goyal,

Albert Groenendijk,

Jacobien J. Hoogerwerf,

S.B. Israelsen,

Mario Karolyi,

Angèle P. M. Kerckhoffs,

Ditte Marie Kirkegaard-Klitbo,

Sukamto Koesnoe,

Chao Luo,

David Chien Lye,

Ntobeko Ntusi,

Sean Wei Xiang Ong,

Letizia Oreni,

Hendri Pangestu,

Matthaios PapadimitriouOlivgeris,

Swandari Paramita,

Erich Pawelka,

Luca Persani,

Ceva Wicaksono Pitoyo,

Plataki,

M. Prasenohadi,

Ignatius Bima Prasetya,

Xiaorui Qu,

Mangala Rajan,

Joanna Bryan Ringel,

Monika M. Safford,

Totok Budi Santoso,

Davide Soranna,

T. Sprong,

C Stoll,

Amin Susanto,

Ari Fahrial Syam,

Camilla Torlasco,

Marjan van Apeldoorn,

Josephine van de Maat,

Karin Veerman,

Annelies Verbon,

Xiaoxiao Wen,

Marjan J. Westerman,

EvertJan Wils,

Yuanqing Xia,

B.E. Young

Publication year - 2021

Publication title -

diabetes care

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 6.636

H-Index - 363

eISSN - 1935-5548

pISSN - 0149-5992

DOI - 10.2337/dc20-2676

Subject(s) - overweight , medicine , diabetes mellitus , obesity , odds ratio , subgroup analysis , risk factor , meta analysis , endocrinology

OBJECTIVE Obesity is an established risk factor for severe coronavirus disease 2019 (COVID-19), but the contribution of overweight and/or diabetes remains unclear. In a multicenter, international study, we investigated if overweight, obesity, and diabetes were independently associated with COVID-19 severity and whether the BMI-associated risk was increased among those with diabetes. RESEARCH DESIGN AND METHODS We retrospectively extracted data from health care records and regional databases of hospitalized adult patients with COVID-19 from 18 sites in 11 countries. We used standardized definitions and analyses to generate site-specific estimates, modeling the odds of each outcome (supplemental oxygen/noninvasive ventilatory support, invasive mechanical ventilatory support, and in-hospital mortality) by BMI category (reference, overweight, obese), adjusting for age, sex, and prespecified comorbidities. Subgroup analysis was performed on patients with preexisting diabetes. Site-specific estimates were combined in a meta-analysis. RESULTS Among 7,244 patients (65.6% overweight/obese), those with overweight were more likely to require oxygen/noninvasive ventilatory support (random effects adjusted odds ratio [aOR], 1.44; 95% CI 1.15–1.80) and invasive mechanical ventilatory support (aOR, 1.22; 95% CI 1.03–1.46). There was no association between overweight and in-hospital mortality (aOR, 0.88; 95% CI 0.74–1.04). Similar effects were observed in patients with obesity or diabetes. In the subgroup analysis, the aOR for any outcome was not additionally increased in those with diabetes and overweight or obesity. CONCLUSIONS In adults hospitalized with COVID-19, overweight, obesity, and diabetes were associated with increased odds of requiring respiratory support but were not associated with death. In patients with diabetes, the odds of severe COVID-19 were not increased above the BMI-associated risk.

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