Journal Article

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

Martin Hower, Andreas L. Birkenfeld, Katrin Sippel, David S. Ludwig, Melanie Stecher, Martina Haselberger, Frank Hanses, Stefan Borgmann, Carolin E. M. Jakob, Alexander von Werder, Christoph Römmele, Jürgen vom Dahl, Yascha Khodamoradi, Martin Heni, Andreas Fritsche, Bjoern Erik Ole Jensen, Kai Wille, Annette Schürmann, Hubert Preißl, Janne Vehreschild, Michael Roden, Baptist Gallwitz, Michele Solimena, Maria Madeleine Rüthrich, Robert Wagner, Norbert Stefan, Martin Hrabe de Angelis, Christiane Piepel, Matthias B. Schulze

2022

Overview

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.

• Publisher: Frontiers Media SA,Frontiers Media S.A
• Subject: Age groups / Cardiovascular disease / Chronic illnesses / Cohort analysis / Coronary vessels / COVID-19 / Data collection / ddc:610 / ddc:no / Diabetes / Edema / Hospitals / Hypertension / impaired metabolic health / Infections / Liver diseases / Medical laboratories / Medicine / Medicine (General) / Medicine ; obesity ; diabetes ; hypertension ; impaired metabolic health ; mortality ; COVID-19 / Metabolism / Middle age / Mortality / Obesity / Obesity ; Diabetes ; Hypertension ; Impaired Metabolic Health ; Mortality ; Covid-19 / Older people / Pandemics / Patients / R5-920 / Risk factors / Severe acute respiratory syndrome coronavirus 2 / Vein & artery diseases