Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;29(7):1223-1230.
doi: 10.1002/oby.23178. Epub 2021 May 14.

Obesity, Ethnicity, and Risk of Critical Care, Mechanical Ventilation, and Mortality in Patients Admitted to Hospital with COVID-19: Analysis of the ISARIC CCP-UK Cohort

Thomas Yates  1   2 , Francesco Zaccardi  1   3 , Nazrul Islam  4   5 , Cameron Razieh  1   2 , Clare L Gillies  1   3 , Claire A Lawson  1 , Yogini Chudasama  3 , Alex Rowlands  1   2 , Melanie J Davies  1   2 , Annemarie B Docherty  6   7 , Peter J M Openshaw  8 , J Kenneth Baillie  9 , Malcolm G Semple  10   11 ; ISARIC4C investigators; Kamlesh Khunti  1   3   12
Affiliations

Obesity, Ethnicity, and Risk of Critical Care, Mechanical Ventilation, and Mortality in Patients Admitted to Hospital with COVID-19: Analysis of the ISARIC CCP-UK Cohort

Thomas Yates et al. Obesity (Silver Spring). 2021 Jul.

Abstract

Objective: The aim of this study was to investigate the association of obesity with in-hospital coronavirus disease 2019 (COVID-19) outcomes in different ethnic groups.

Methods: Patients admitted to hospital with COVID-19 in the United Kingdom through the Clinical Characterisation Protocol UK (CCP-UK) developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) were included from February 6 to October 12, 2020. Ethnicity was classified as White, South Asian, Black, and other minority ethnic groups. Outcomes were admission to critical care, mechanical ventilation, and in-hospital mortality, adjusted for age, sex, and chronic diseases.

Results: Of the participants included, 54,254 (age = 76 years; 45.0% women) were White, 3,728 (57 years; 41.1% women) were South Asian, 2,523 (58 years; 44.9% women) were Black, and 5,427 (61 years; 40.8% women) were other ethnicities. Obesity was associated with all outcomes in all ethnic groups, with associations strongest for black ethnicities. When stratified by ethnicity and obesity status, the odds ratios for admission to critical care, mechanical ventilation, and mortality in black ethnicities with obesity were 3.91 (3.13-4.88), 5.03 (3.94-6.63), and 1.93 (1.49-2.51), respectively, compared with White ethnicities without obesity.

Conclusions: Obesity was associated with an elevated risk of in-hospital COVID-19 outcomes in all ethnic groups, with associations strongest in Black ethnicities.

PubMed Disclaimer

Conflict of interest statement

KK is supported by the NIHR ARC EM and TY by the NIHR BRC. KK is Director for the University of Leicester Centre for Black and Minority Ethnic Health, trustee of the South Asian Health Foundation, national NIHR ARC lead for Ethnicity and Diversity, and a member of the Independent Scientific Advisory Group for Emergencies (SAGE) and Chair of the SAGE subgroup on ethnicity and COVID‐19. MGS is a member of SAGE COVID‐19. MGS reports grants from DHSC NIHR UK, grants from MRC UK, grants from HPRU in Emerging and Zoonotic Infections, University of Liverpool, during the conduct of the study, and other support from Integrum Scientific LLC, Greensboro, North Carolina, outside the submitted work. The other authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Associations of obesity (compared with those without obesity) with critical care, mechanical ventilation, and mortality for each ethnicity stratified by age, sex, and chronic disease. Error bars display 95% CI. Sex strata adjusted for age, diabetes, chronic heart disease, chronic kidney disease, chronic pulmonary disease, and cancer. Age strata adjusted for sex, diabetes, chronic heart disease, chronic kidney disease, chronic pulmonary disease, and cancer. Chronic disease strata adjusted for age and sex.
Figure 2
Figure 2
Risk of admittance to critical care, mechanical ventilation, and mortality across categories of obesity and ethnicity compared with White individuals without obesity. Error bars display 95% CI. Adjusted for age, sex, diabetes, chronic heart disease, chronic kidney disease, chronic pulmonary disease, and cancer.
See this image and copyright information in PMC

References

    1. Williamson EJ, Walker AJ, Bhaskaran K, et al. Factors associated with COVID‐19‐related death using OpenSAFELY. Nature 2020;584:430‐436. - PMC - PubMed
    1. Office for National Statistics (ONS) . Coronavirus (COVID‐19) related deaths by ethnic group, England and Wales: 2 March 2020 to 10 April 2020. Published May 7, 2020. Accessed July 28, 2020. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri...
    1. Office for National Statistics (ONS) . Updating ethnic contrasts in deaths involving the coronavirus (COVID‐19), England and Wales: deaths occurring 2 March to 28 July 2020. Published October 16, 2020. Accessed October 26, 2020. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri...
    1. Pan D, Sze S, Minhas JS, et al. The impact of ethnicity on clinical outcomes in COVID‐19: a systematic review. EClinicalMedicine 2020;23:100404. doi:10.1016/j.eclinm.2020.100404 - DOI - PMC - PubMed
    1. Sze S, Pan D, Nevill CR, et al. Ethnicity and clinical outcomes in COVID‐19: a systematic review and meta‐analysis. EClinicalMedicine 2020;29:100630. doi:10.1016/j.eclinm.2020.100630 - DOI - PMC - PubMed

Publication types

MeSH terms