“Executive summary: … Evidence on the links between weight status and COVID-19 outcomes are drawn primarily from three sources: retrospective cohort studies, clinical audits of patients with COVID-19 in hospital and routine primary care records with data linkage to outcomes. This evidence suggests excess weight is associated with an increased risk of the following for COVID-19: a positive test, hospitalisation, advanced levels of treatment (including mechanical ventilation or admission to intensive or critical care) and death. The risks seem to increase progressively with increasing BMI above the healthy weight range, even after adjustment for potential confounding factors, including demographic and socio-economic factors…
Hospitalization: … Hamer et al reported that, compared with patients with BMI <25kg/m2, those living with overweight or obesity had an increased risk of hospitalisation, RR 1.32 and 1.97 respectively (after adjusting for age, sex, education, ethnicity, diabetes, hypertension, cardiovascular disease). In New York, Petrilli et al reported that people living with obesity (BMI 30-39.9kg/m2) or severe obesity (BMI ≥40kg/m2) and diagnosed with COVID-19 (median age of 52 years), were 4 and 6 times, respectively, more likely to be hospitalised compared with patients with COVID-19 and a BMI<30kg/m2 …
Admission to intensive/critical care: … Hippisley-Cox et al analysed general practice data for over 8 million people, of which 19,486 had tested positive for COVID-19 and 1286 were admitted to ICU. The authors reported that patients living with overweight (BMI ≥25-29.9kg/m2), obesity (BMI ≥30-34.9kg/m2) or severe obesity (BMI ≥35kg/m2), compared with patients with a BMI ≥20-24.9kg/m2, had increased odds of ICU admission of 1.64, 2.59 and 4.35 [emphasis added] (adjusted for age, sex, ethnicity, deprivation co-morbidity, treatment and other factors)…
Risk of mortality: Williamson et al looked at primary care data on 17 million adults, of which there were 10,926 COVID-19 deaths. This data showed an increasing risk of death with increasing BMI (fully adjusted for age, sex, ethnicity, deprivation and co-morbidities) with HR 1.05, 1.40 and 1.92 for people with a BMI between 30-34.9kg/m2, ≥35-39.9kg/m2 and ≥40kg/m2 respectively, relative to BMI <30kg/m2 [emphasis added].
Docherty et al reported that of patients hospitalised, in 208 UK hospitals, there was a 33% increased risk of mortality (after adjusting for age, sex, and major comorbidities) for those recognised by clinical staff as living with obesity.”