Global association of obesity and COVID-19 death rates

Adams, Mary L

ImportanceCOVID-19 was responsible for an enormous global death toll with large variation among countries. ObjectiveTo examine the possible impact of obesity on COVID-19 death rates. DesignMeasure associations between obesity rates in 2016 and COVID-19 deaths/million population through 2/25/2021, across countries. SettingGlobal Participants167 countries for which obesity and death data were available, grouped by population size, with multiples of 10 countries in each of 8 groups plus a group including all 57 countries with obesity rates <15%. Outcome and measuresUsing Excel, COVID-19 deaths/million were regressed on the obesity rate for each country, based on obesity being a key factor in COVID hospitalizations and deaths. Using the least squares formula for the best fit for each model, R2, components of the formula, and the percentage of world population represented, were recorded for each group. ResultsObesity rates ranged from 2.1% to 37.9% and death rates ranged from 0.4/million to 1,892/million for groups representing up to 91% of global population. Results for the 8 population groups had R2 from 0.30 to 0.90 with slopes of the fitted line ranging from 27.9-51.0. Countries with obesity rates <15% had consistently low death rates ([≤]233/million), R2 of 0.003 and slope of the line=1.01. ConclusionsFor most countries about one-third of the difference in COVID death rates was due to obesity while in countries with obesity <15%, consistently low death rates were not associated with obesity. Reduced obesity rates could potentially have lowered the COVID death toll.