Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China

Background: Patients with obesity are at increased risk of exacerbations from viral respiratory infections. However, the association of obesity with severity of corona virus disease 2019 (COVID-19) is unclear. We hereby examined this association using data from the only referral hospital in Shenzhen, China. Methods: 383 COVID-19 patients admitted from 11 January to 16 February 2020 in the Third People’s Hospital of Shenzhen, China were included. Underweight was defined by body mass index (BMI) lower than 18·5 kg/m2, normal weight by 18·5-23·9 kg/m2 , overweight by 24·0- 27·9 kg/m2 and obesity as ≥28 kg/m2. Findings: Of them, 53·1% were normal weight, 4·2% were underweight, 32·0% were overweight, and 10·7% were obese. Patients with obesity, versus without, were tended to have cough (P=0·03) and fever (P=0·06). After adjusting for potential confounders, compared to normal weight, overweight showed 86% higher, and obesity group showed 2·42-fold higher odds of developing severe pneumonia. Despite a non-significant sex interaction was found (P=0·09), the association appeared to be more pronounced in men than in women. The odds ratios (95% confidence intervals) for severe pneumonia in overweight and obesity was 1·96 (0·78-4·98) and 5·70 (1·83-17·76) in men, and 1·51 (0·57-4·01) and 0·71 (0·07-7·3) in women, respectively. Interpretation: This is the first study showing that obesity, especially in men, significantly increases the risk of developing severe pneumonia in COVID-19 patients. As the 2019n-Cov may continue to spread worldwide, clinicians should maintain a high level of attention in obese patients. Obese patients should be carefully managed with prompt and aggressive treatment. Funding Statement: Sanming Project of Medicine in Shenzhen (SZSM201412003, SZSM201512005) and Bill & Melinda Gates Foundations, Shenzhen Science and Technology Research and Development Project (202002073000001). Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: This study was approved by the Ethics Committee of The Third People’s Hospital of Shenzhen (2020 108). All patients provided signed informed consent at admission.