Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry

Frontiers in Medicine

article

Norbert Stefan¹  Katrin Sippel¹  Martin Heni¹  Andreas Fritsche¹  Robert Wagner¹  Carolin E. M. Jakob⁴  Hubert Preißl¹  Alexander von Werder⁵  Yascha Khodamoradi⁷  Stefan Borgmann⁸  Maria Madeleine Rüthrich⁹  Frank Hanses^1,10  Martina Haselberger^1,11  Christiane Piepel^1,12  Martin Hower^1,13  Jürgen vom Dahl^1,14  Kai Wille^1,15  Christoph Römmele^1,16  Janne Vehreschild³  Melanie Stecher⁴  Michele Solimena³  Michael Roden³  Annette Schürmann³  Baptist Gallwitz²  Martin Hrabe de Angelis³  David S. Ludwig^2,24  Matthias B. Schulze³  Bjoern Erik Ole Jensen^2,28  Andreas L. Birkenfeld¹ 

[1] Institute of Diabetes Research and Metabolic Diseases ,(IDM) of the Helmholtz Center Munich;Department of Internal Medicine IV, University Hospital of Tübingen;German Center for Diabetes Research;Department of Internal Medicine I, Faculty of Medicine, University Hospital Cologne, Cologne, University of Cologne;German Center for Infection Research;Department of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich;Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt;Department of Infectious Diseases and Infection Control, Ingolstadt Hospital;Department of Internal Medicine II, University Hospital Jena;Emergency Department, University Hospital Regensburg;Department of Internal Medicine I, Passau Hospital;Department of Internal Medicine I, Hospital Bremen-Center;Department for Pneumology, Infectiology, Internal Medicine and Intensive Care;Division of Cardiology, Hospital Maria Hilf Mönchengladbach;University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, University of Bochum;Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg;Department of Internal Medicine, Hematology and Oncology, University Hospital Cologne, Goethe University Frankfurt;Helmholtz Center Munich, Faculty of Medicine, Paul Langerhans Institute Dresden, University Hospital, Carl Gustav Carus, Technische Universität Dresden;Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich-Heine University;Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich- Heine University;Department of Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke;Institute of Experimental Genetics;TUM School of Life Sciences ,(SoLS), Chair of Experimental Genetics, Technische Universität München;New Balance Foundation Obesity Prevention Center, Boston Children's Hospital;Department of Pediatrics, Harvard Medical School;Department of Nutrition, Harvard T.H. Chan School of Public Health;Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke;Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf

关键词: obesity;    diabetes;    hypertension;    impaired metabolic health;    mortality;    COVID-19;   

DOI  :  10.3389/fmed.2022.875430

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Advanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021. A total of 3,163 patients with SARS-COV-2 diagnosis in the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort were studied. LEOSS is a European non-interventional multi-center cohort study established in March 2020 to investigate the epidemiology and clinical course of SARS-CoV-2 infection. Data from hospitalized patients and those who received ambulatory care, with a positive SARS-CoV-2 test, were included in the study. An additive effect of obesity, diabetes and hypertension on the risk of mortality was observed, which was particularly strong in young and middle-aged patients. Compared to young and middle-aged (18–55 years) patients without obesity, diabetes and hypertension (non-obese and metabolically healthy; n = 593), young and middle-aged adult patients with all three risk parameters (obese and metabolically unhealthy; n = 31) had a similar adjusted increased risk of mortality [OR 7.42 (95% CI 1.55–27.3)] as older (56–75 years) non-obese and metabolically healthy patients [ n = 339; OR 8.21 (95% CI 4.10–18.3)]. Furthermore, increased CRP levels explained part of the elevated risk of COVID-19-related mortality with age, specifically in the absence of obesity and impaired metabolic health. In conclusion, the modifiable risk factors obesity, diabetes and hypertension increase the risk of COVID-19-related mortality in young and middle-aged patients to the level of risk observed in advanced age.

【 授权许可】

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