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Title: Obesity and COVID-19 in Adult Patients With Diabetes
Authors: Cao, P
Song, Y
Zhuang, Z 
Ran, J
Xu, L
Geng, Y
Han, L 
Zhao, S
Qin, J 
He, D 
Wu, F
Yang, L
Issue Date: May-2021
Source: Diabetes, May 2021, v. 70, no. 5, p. 1061-1069
Abstract: Obesity has caused wide concerns due to its high prevalence in patients with severe coronavirus disease 2019 (COVID-19). Coexistence of diabetes and obesity could cause an even higher risk of severe outcomes due to immunity dysfunction. We conducted a retrospective study in 1,637 adult patients who were admitted into an acute hospital in Wuhan, China. Propensity score–matched logistic regression was used to estimate the risks of severe pneumonia and requiring in-hospital oxygen therapy associated with obesity. After adjustment for age, sex, and comorbidities, obesity was significantly associated with higher odds of severe pneumonia (odds ratio [OR] 1.47 [95% CI 1.15–1.88]; P = 0.002) and oxygen therapy (OR 1.40 [95% CI 1.10–1.79]; P = 0.007). Higher ORs of severe pneumonia due to obesity were observed in men, older adults, and those with diabetes. Among patients with diabetes, overweight increased the odds of requiring in-hospital oxygen therapy by 0.68 times (P = 0.014) and obesity increased the odds by 1.06 times (P = 0.028). A linear dose-response curve between BMI and severe outcomes was observed in all patients, whereas a U-shaped curve was observed in those with diabetes. Our findings provide important evidence to support obesity as an independent risk factor for severe outcomes of COVID-19 infection in the early phase of the ongoing pandemic.
Publisher: American Diabetes Association
Journal: Diabetes 
ISSN: 0012-1797
EISSN: 1939-327X
DOI: 10.2337/db20-0671
Rights: © 2021 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at https://www.diabetesjournals .org/content/license.
This is a post-peer-review, pre-copyedit version of an article published in Diabetes. The final authenticated version is available online at:
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