PLoS ONE (Jan 2010)

Morbid obesity as a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1) disease.

  • Oliver W Morgan,
  • Anna Bramley,
  • Ashley Fowlkes,
  • David S Freedman,
  • Thomas H Taylor,
  • Paul Gargiullo,
  • Brook Belay,
  • Seema Jain,
  • Chad Cox,
  • Laurie Kamimoto,
  • Anthony Fiore,
  • Lyn Finelli,
  • Sonja J Olsen,
  • Alicia M Fry

DOI
https://doi.org/10.1371/journal.pone.0009694
Journal volume & issue
Vol. 5, no. 3
p. e9694

Abstract

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BACKGROUND: Severe illness due to 2009 pandemic A(H1N1) infection has been reported among persons who are obese or morbidly obese. We assessed whether obesity is a risk factor for hospitalization and death due to 2009 pandemic influenza A(H1N1), independent of chronic medical conditions considered by the Advisory Committee on Immunization Practices (ACIP) to increase the risk of influenza-related complications. METHODOLOGY/PRINCIPAL FINDINGS: We used a case-cohort design to compare cases of hospitalizations and deaths from 2009 pandemic A(H1N1) influenza occurring between April-July, 2009, with a cohort of the U.S. population estimated from the 2003-2006 National Health and Nutrition Examination Survey (NHANES); pregnant women and children or=20 year olds, hospitalization was associated with being morbidly obese (BMI>or=40) for individuals with ACIP-recognized chronic conditions (OR = 4.9, 95% CI 2.4-9.9) and without ACIP-recognized chronic conditions (OR = 4.7, 95%CI 1.3-17.2). Among 2-19 year olds, hospitalization was associated with being underweight (BMIor=20 years without ACIP-recognized chronic medical conditions death was associated with obesity (OR = 3.1, 95%CI: 1.5-6.6) and morbid obesity (OR = 7.6, 95%CI 2.1-27.9). CONCLUSIONS/SIGNIFICANCE: Our findings support observations that morbid obesity may be associated with hospitalization and possibly death due to 2009 pandemic H1N1 infection. These complications could be prevented by early antiviral therapy and vaccination.