BMI and future risk for COVID-19 infection and death across sex, age and ethnicity: Preliminary findings from UK biobank

Sattar, Naveed; Ho, Frederick K.; Gill, Jason MR.; Ghouri, Nazim; Gray, Stuart R.; Celis-Morales, Carlos A.; Katikireddi, S. Vittal; Berry, Colin; Pell, Jill P.; McMurray, John JV.; Welsh, Paul

AIMS: We examined the link between BMI and risk of a positive test for SARS-CoV-2 and risk of COVID-19-related death among UK Biobank participants. METHODS: Among 4855 participants tested for SARS-CoV-2 in hospital, 839 were positive and of these 189 died from COVID-19. Poisson models with penalised thin plate splines were run relating exposures of interest to test positivity and case-fatality, adjusting for confounding factors. RESULTS: BMI was associated strongly with positive test, and risk of death related to COVID-19. The gradient of risk in relation to BMI was steeper in those under 70, compared with those aged 70 years or older for COVID-19 related death (P(interaction) = 0.03). BMI was more strongly related to test positivity (P(interaction) = 0.010) and death (P(interaction) = 0.002) in non-whites (predominantly South Asians and Afro-Caribbean's), compared with whites. CONCLUSIONS: These data add support for adiposity being more strongly linked to COVID-19-related deaths in younger people and non-white ethnicities. If future studies confirm causality, lifestyle interventions to improve adiposity status may be important to reduce the risk of COVID-19 in all, but perhaps particularly, non-white communities.