Obesity during the COVID-19 pandemic: both cause of high risk and potential effect of lockdown? A population-based electronic health record study.
Public Health
; 191: 41-47, 2021 Feb.
Article
en En
| MEDLINE
| ID: mdl-33497994
ABSTRACT
OBJECTIVES:
Obesity is a modifiable risk factor for coronavirus disease 2019 (COVID-19)-related mortality. We estimated excess mortality in obesity, both 'direct', through infection, and 'indirect', through changes in health care, and also due to potential increasing obesity during lockdown. STUDYDESIGN:
The study design of this study is a retrospective cohort study and causal inference methods.METHODS:
In population-based electronic health records for 1,958,638 individuals in England, we estimated 1-year mortality risk ('direct' and 'indirect' effects) for obese individuals, incorporating (i) pre-COVID-19 risk by age, sex and comorbidities, (ii) population infection rate and (iii) relative impact on mortality (relative risk [RR] 1.2, 1.5, 2.0 and 3.0). Using causal inference models, we estimated impact of change in body mass index (BMI) and physical activity during 3-month lockdown on 1-year incidence for high-risk conditions (cardiovascular diseases, diabetes, chronic obstructive pulmonary disease and chronic kidney disease), accounting for confounders.RESULTS:
For severely obese individuals (3.5% at baseline), at 10% population infection rate, we estimated direct impact of 240 and 479 excess deaths in England at RR 1.5 and 2.0, respectively, and indirect effect of 383-767 excess deaths, assuming 40% and 80% will be affected at RR = 1.2. Owing to BMI change during the lockdown, we estimated that 97,755 (5.4% normal weight to overweight, 5.0% overweight to obese and 1.3% obese to severely obese) to 434,104 individuals (15% normal weight to overweight, 15% overweight to obese and 6% obese to severely obese) would be at higher risk for COVID-19 over one year.CONCLUSIONS:
Prevention of obesity and promotion of physical activity are at least as important as physical isolation of severely obese individuals during the pandemic.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pandemias
/
COVID-19
/
Obesidad
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Public Health
Año:
2021
Tipo del documento:
Article
País de afiliación:
Reino Unido