Independent role of morbid obesity as a risk factor for COVID-19 hospitalization: a Spanish population-based cohort study.

Fresán, Ujué; Guevara, Marcela; Elía, Fernando; Albéniz, Esther; Burgui, Cristina; Castilla, Jesús

OBJECTIVES To analyze the association between morbid obesity and COVID-19 hospitalization and severe disease. METHODS We evaluated the incidence of hospitalization for laboratory-confirmed COVID-19 in a prospective population-based cohort of 433,995 persons aged 25-79 years in Spain during March and April 2020. Persons with and without morbid obesity were compared using Poisson regression to estimate the adjusted relative risk (aRR) of morbid obesity for COVID-19 hospitalization and for severe disease (intensive care unit admission or death). Differences in the effect by age, sex and chronic conditions were evaluated. RESULTS Individuals with morbid obesity had higher risk of hospitalization (aRR=2.20; 95% confidence interval (CI) 1.66-2.93) and severe COVID-19 (aRR=2.30; 95%CI 1.20-4.40). In people younger than 50 years, these effects were more pronounced (aRR=5.02, 95%CI 3.19-7.90; and aRR=13.80, 95%CI 3.11-61.17, respectively), while no significant effects were observed in those aged 65-79 years (aRR=1.22, 95%CI 0.70-2.12; and aRR=1.42, 95%CI 0.52-3.88, respectively). Sex and chronic conditions did not modify the effect of morbid in any of the outcomes. CONCLUSIONS Morbid obesity is a relevant risk factor for COVID-19 hospitalization and severity in young adults, of a similar magnitude as aging. Tackling current obesity pandemic could alleviate impact of chronic and infectious diseases.