Association Between COVID-19 Morbidity, Mortality and Country's Gross Domestic Product, Overweight and Obesity Prevalence: A Cross-Sectional Study

Background: Studies showed that mortality and morbidity rates from COVID-19 are uneven across world countries. The spread of COVID-19 depends on a lot of social and economic factors. Aim of the study was to study an influence of country’s gross domestic product, population prevalence of overweight and obesity on COVID-19 morbidity and mortality. Methods: A cross-sectional study with correlation-regression. The study has two phases: correlation-regression interrelations in 1) all world countries; 2) all world non-island countries. The study includes data from 218 world countries: COVID-19 morbidity rate, COVID-19 mortality rate, GDP (at purchasing power parity) per capita, the prevalence of overweight among adults (both sexes), and prevalence of obesity among adults (both sexes). Pearson correlation, regression analysis, and Fisher’s r to z transformation (Z-score) were used. Results: An average percent of the prevalence of overweight among adults (both sexes) in included 176 world countries to the 2019 year was 47.31± 15.99%, prevalence of obesity was 18.34± 9.64%. During three years (2016-2019) the prevalence of overweight and obesity among adults has grown by 21.2% and 40.8%, respectively. Data of the 176 world countries provides significant correlations between COVID-19 morbidity and: GDP (r=0.517; p<0.0001), overweight prevalence (r=0.54; p<0.0001), obesity prevalence (r=0.528; p<0.0001); COVID-19 mortality and: GDP (r=0.344; p<0.0001), overweight prevalence (r=0.514; p<0.0001), obesity prevalence (r=0.489; p<0.0001); GDP and: overweight prevalence (r=0.507; p<0.0001), obesity prevalence (r=0.523; p<0.0001). Data of 143 world non-island countries also provides highly significant correlations between COVID-19 morbidity and: GDP (r=0.616; p 0.05). Conclusions: The study with correlation-regression evidenced a significant direct impact of overweight and obesity prevalence on an increase in COVID-19 morbidity and mortality. The population of countries with higher GDP has accordingly a high overweight and obesity prevalence. Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. KO is supported by the Ministry of health of the Republic of Kazakhstan, 2020-2021 Declaration of Interests: The authors declare that they have no any competing interests (financial, professional, or personals) that are relevant to the manuscript. We have read and understood the journal policy on declaration of interests and have no interests to declare.