Frontiers in Medicine (May 2022)

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

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

DOI
https://doi.org/10.3389/fmed.2022.875430
Journal volume & issue
Vol. 9

Abstract

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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.

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