Obesity may be less impactful for older COVID-19 patients with type 2 diabetes
medwireNews: Obesity is a significant predictor of poor COVID-19 outcomes in patients who also have type 2 diabetes, but only in those up to the age of 75 years, report French researchers.
A previous interim analysis of the French multicenter CORONADO study identified obesity as the only preadmission factor with a significant bearing on the outcomes of people with type 2 diabetes who are hospitalized with COVID-19.
But this latest analysis involving 1965 patients shows that the effect of obesity varies according to age.
“The deleterious impact of obesity on COVID-19 prognosis seems to be much less pronounced in the elderly and advanced age by itself must be considered as a major risk for severe COVID-19 outcomes in all people with [type 2 diabetes], irrespective of BMI status,” say the researchers.
The study participants were admitted to 68 French hospitals between March and April 2020. The primary outcome was death or need for invasive mechanical ventilation by day 7 of hospitalization; the individual components occurred in 9.7% and 19.6% of patients, respectively.
For patients younger than 75 years, having a BMI of 25.0–29.9 kg/m² was not significantly associated with the risk for the primary outcome relative to having a lower BMI, but having a BMI of 30.0 kg/m2 or higher increased the risk a significant 2.32-fold.
By contrast, there was no significant association between BMI and the primary outcome among patients who were aged 75 years or older, report co-lead researchers Pierre Gourdy (Hôpital Rangueil, Toulouse) and Bertrand Cariou (Hôpital Guillaume et René Laennec, Nantes) and team. These findings were adjusted for factors including sex, smoking status, cardiovascular disease, hypertension, and antidiabetes medications.
Nearly 80% of the cohort as a whole was overweight or obese, and the team found a graded association between WHO BMI category and risk for the primary outcome, which was driven by risk for mechanical ventilation.
Patients who were aged 75 years or older were however much less likely to require mechanical ventilation by day 7 than younger patients were, at rates of around 5–15% versus 20–30%, although they were more likely to die, at approximately 20% versus 3–10%.
The researchers say their finding of a different response in the oldest age group of COVID-19 patients with type 2 diabetes is in line with previous research.
“Altogether, this reinforces the need for a specific clinical management and dedicated trials in elderly people affected by COVID-19,” they write in Diabetes, Obesity and Metabolism.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group
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