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Observational Study
. 2021 Sep;45(9):1986-1994.
doi: 10.1038/s41366-021-00861-y. Epub 2021 May 17.

Weight trajectories and abdominal adiposity in COVID-19 survivors with overweight/obesity

Luigi Di Filippo  1   2 , Rebecca De Lorenzo  1   3 , Elena Cinel  1   3 , Elisabetta Falbo  1   3 , Marica Ferrante  1   3 , Marta Cilla  3 , Sabina Martinenghi  3 , Giordano Vitali  3 , Emanuele Bosi  1   3 , Andrea Giustina  1   2 , Patrizia Rovere-Querini  1   3 , Caterina Conte  4   5
Affiliations
Observational Study

Weight trajectories and abdominal adiposity in COVID-19 survivors with overweight/obesity

Luigi Di Filippo et al. Int J Obes (Lond). 2021 Sep.

Abstract

Background: COVID-19 is associated with unintentional weight loss. Little is known on whether and how patients regain the lost weight. We assessed changes in weight and abdominal adiposity over a three-month follow-up after discharge in COVID-19 survivors.

Methods: In this sub-study of a large prospective observational investigation, we collected data from individuals who had been hospitalized for COVID-19 and re-evaluated at one (V1) and three (V2) months after discharge. Patient characteristics upon admission and anthropometrics, waist circumference and hunger levels assessed during follow-up were analyzed across BMI categories.

Results: One-hundred-eighty-five COVID-19 survivors (71% male, median age 62.1 [54.3; 72.1] years, 80% with overweight/obesity) were included. Median BMI did not change from admission to V1 in normal weight subjects (-0.5 [-1.2; 0.6] kg/m2, p = 0.08), but significantly decreased in subjects with overweight (-0.8 [-1.8; 0.3] kg/m2, p < 0.001) or obesity (-1.38 [-3.4; -0.3] kg/m2, p < 0.001; p < 0.05 vs. normal weight or obesity). Median BMI did not change from V1 to V2 in normal weight individuals (+0.26 [-0.34; 1.15] kg/m2, p = 0.12), but significantly increased in subjects with overweight (+0.4 [0.0; 1.0] kg/m2, p < 0.001) or obesity (+0.89 [0.0; 1.6] kg/m2, p < 0.001; p = 0.01 vs. normal weight). Waist circumference significantly increased from V1 to V2 in the whole group (p < 0.001), driven by the groups with overweight or obesity. At multivariable regression analyses, male sex, hunger at V1 and initial weight loss predicted weight gain at V2.

Conclusions: Patients with overweight or obesity hospitalized for COVID-19 exhibit rapid, wide weight fluctuations that may worsen body composition (abdominal adiposity). CLINICALTRIALS.

Gov registration: NCT04318366.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Changes in BMI.
BMI changes from hospital admission to V1 (A), from V1 to V2 (B) and from hospital admission to V2 (C). BMI Body Mass Index, OB Obesity, OW Overweight, NW Normal Weight.
Fig. 2
Fig. 2. Change in hunger from the 1-month to the 3-month follow-up visit in subjects with normal weight, overweight or obesity.
VAS visual analog scale.
Fig. 3
Fig. 3. Change in waist circumference from the 1-month to the 3-month follow-up visit in subjects with normal weight, overweight or obesity.
WC Waist circumference.
Fig. 4
Fig. 4. Abdominal obesity.
Prevalence of abdominal obesity (as defined as a waist circumference ≥88 cm in women and ≥102 cm in men) at one (V1) and three (V2) months after hospital discharge in COVID-19 survivors with normal weight (NW), overweight (OW) or obesity (OB). *p < 0.05 vs. NW; #p < .05 vs. OW.
See this image and copyright information in PMC

References

    1. Di Filippo L, De Lorenzo R, D’Amico M, Sofia V, Roveri L, Mele R, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: a post-hoc analysis of a prospective cohort study. Clin Nutr. 2020. 10.1016/j.clnu.2020.10.043. - PMC - PubMed
    1. Morley JE, Kalantar-Zadeh K, Anker SD. COVID-19: a major cause of cachexia and sarcopenia? J Cachexia Sarcopenia Muscle. 2020;11:863–5. doi: 10.1002/jcsm.12589. - DOI - PMC - PubMed
    1. Harrington M, Gibson S, Cottrell RC. A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Nutr Res Rev. 2009;22:93–108. doi: 10.1017/S0954422409990035. - DOI - PubMed
    1. Myers J, Lata K, Chowdhury S, McAuley P, Jain N, Froelicher V. The obesity paradox and weight loss. Am J Med. 2011;124:924–30. doi: 10.1016/j.amjmed.2011.04.018. - DOI - PubMed
    1. Chan KS, Mourtzakis M, Aronson Friedman L, Dinglas VD, Hough CL, Ely EW, et al. Evaluating muscle mass in survivors of acute respiratory distress syndrome: a 1-year multicenter longitudinal study. Crit Care Med. 2018;46:1238–46. doi: 10.1097/CCM.0000000000003183. - DOI - PMC - PubMed

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