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Multicenter Study
. 2021 Feb;23(2):391-403.
doi: 10.1111/dom.14228. Epub 2020 Nov 6.

Relationship between obesity and severe COVID-19 outcomes in patients with type 2 diabetes: Results from the CORONADO study

Sarra Smati  1 , Blandine Tramunt  2 , Matthieu Wargny  3 , Cyrielle Caussy  4   5 , Bénédicte Gaborit  6 , Camille Vatier  7   8 , Bruno Vergès  9 , Deborah Ancelle  10 , Coralie Amadou  11 , Leila A Bachir  12 , Olivier Bourron  13   14   15 , Christine Coffin-Boutreux  16 , Sara Barraud  17 , Anne Dorange  18 , Bénédicte Fremy  19 , Jean-François Gautier  20   21 , Natacha Germain  22 , Etienne Larger  23 , Stéphanie Laugier-Robiolle  24 , Laurent Meyer  25 , Arnaud Monier  26 , Isabelle Moura  27 , Louis Potier  28 , Nadia Sabbah  29   30 , Dominique Seret-Bégué  31 , Patrice Winiszewski  32 , Matthieu Pichelin  1 , Pierre-Jean Saulnier  33 , Samy Hadjadj  1 , Bertrand Cariou  1 , Pierre Gourdy  2 ; CORONADO investigators
Affiliations
Multicenter Study

Relationship between obesity and severe COVID-19 outcomes in patients with type 2 diabetes: Results from the CORONADO study

Sarra Smati et al. Diabetes Obes Metab. 2021 Feb.

Abstract

Aim: To assess the relationship between body mass index (BMI) classes and early COVID-19 prognosis in inpatients with type 2 diabetes (T2D).

Methods: From the CORONAvirus-SARS-CoV-2 and Diabetes Outcomes (CORONADO) study, we conducted an analysis in patients with T2D categorized by four BMI subgroups according to the World Health Organization classification. Clinical characteristics and COVID-19-related outcomes (i.e. intubation for mechanical ventilation [IMV], death and discharge by day 7 [D7]) were analysed according to BMI status.

Results: Among 1965 patients with T2D, 434 (22.1%) normal weight (18.5-24.9 kg/m2 , reference group), 726 (36.9%) overweight (25-29.9 kg/m2 ) and 805 (41.0%) obese subjects were analysed, including 491 (25.0%) with class I obesity (30-34.9 kg/m2 ) and 314 (16.0%) with class II/III obesity (≥35 kg/m2 ). In a multivariable-adjusted model, the primary outcome (i.e. IMV and/or death by D7) was significantly associated with overweight (OR 1.65 [1.05-2.59]), class I (OR 1.93 [1.19-3.14]) and class II/III obesity (OR 1.98 [1.11-3.52]). After multivariable adjustment, primary outcome by D7 was significantly associated with obesity in patients aged younger than 75 years, while such an association was no longer found in those aged older than 75 years.

Conclusions: Overweight and obesity are associated with poor early prognosis in patients with T2D hospitalized for COVID-19. Importantly, the deleterious impact of obesity on COVID-19 prognosis was no longer observed in the elderly, highlighting the need for specific management in this population.

Keywords: COVID-19, elderly, mechanical ventilation, obesity, prognosis, type 2 diabetes.

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Conflict of interest statement

C.C. reports personal fees from Novo Nordisk, Gilead, MSD, Eli Lilly and Astra Zeneca and grant support from Gilead. L.P. reports personal fees and non‐financial support from Sanofi, personal fees and non‐financial support from Eli Lilly, personal fees and non‐financial support from Novo Nordisk and personal fees and non‐financial support from MSD. B.F. reports personal fees and non‐financial support from Sanofi, Orkyn, Isis, MSD, NHC, Pfizer, Vitalair, Eli Lilly, Novo Nordisk, Merck and Servier. J.‐F.G. reports personal fees and non‐financial support from Eli Lilly, personal fees and non‐financial support from Novo Nordisk, personal fees and non‐financial support from Gilead and personal fees and non‐financial support from Astra Zeneca. A.M. reports personal fees support from Novo Nordisk. D.S.‐B. reports non‐financial support from Novo Nordisk, Sanofi, MSD and Lilly. M.P. reports personal fees and non‐financial support from Novo Nordisk, non‐financial support from Sanofi and non‐financial support from Amgen. S.H. reports personal fees and non‐financial support from Astra Zeneca, grants and personal fees from Bayer, personal fees from Boehringer Ingelheim, grants from Dinno Santé, personal fees from Eli Lilly, non‐financial support from LVL, personal fees and non‐financial support from Merck Sharpe Dome, personal fees from Novartis, grants from Pierre Fabre Santé, personal fees and non‐financial support from Sanofi, personal fees and non‐financial support from Servier and personal fees from Valbiotis. B.C. reports grants and personal fees from Amgen, personal fees from Astra‐Zeneca, personal fees from Akcea, personal fees from Genfit, personal fees from Gilead, personal fees from Eli Lilly, personal fees from Novo Nordisk, personal fees from Merck (MSD), grants and personal fees from Sanofi and grants and personal fees from Regeneron. P.G. reports personal fees from Abbott, personal fees from Amgen, personal fees from Astra‐Zeneca, personal fees from Boehringer Ingelheim, personal fees from Eli Lilly, personal fees from Merck Sharp and Dohme, personal fees from Mundipharma, grants and personal fees from Novo Nordisk, personal fees from Sanofi and personal fees from Servier. All of the other authors declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Flowchart. BMI, body mass index; IMV, intubation for mechanical ventilation; T2D, type 2 diabetes
FIGURE 2
FIGURE 2
Distribution of COVID‐19‐related outcomes by day 7 per age and body mass index (BMI) subgroups: A) Primary outcome; B) IMV; C) Death; D) Hospital discharge
See this image and copyright information in PMC

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