Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry
Advanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021....
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.875430/full |
| _version_ | 1828553744537616384 |
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| author | Norbert Stefan Norbert Stefan Norbert Stefan Katrin Sippel Katrin Sippel Katrin Sippel Martin Heni Martin Heni Martin Heni Andreas Fritsche Andreas Fritsche Andreas Fritsche Robert Wagner Robert Wagner Robert Wagner Carolin E. M. Jakob Carolin E. M. Jakob Hubert Preißl Hubert Preißl Alexander von Werder Alexander von Werder Yascha Khodamoradi Stefan Borgmann Maria Madeleine Rüthrich Frank Hanses Martina Haselberger Christiane Piepel Martin Hower Jürgen vom Dahl Kai Wille Christoph Römmele Janne Vehreschild Janne Vehreschild Janne Vehreschild Melanie Stecher Melanie Stecher Michele Solimena Michele Solimena Michael Roden Michael Roden Michael Roden Annette Schürmann Annette Schürmann Baptist Gallwitz Martin Hrabe de Angelis Martin Hrabe de Angelis Martin Hrabe de Angelis David S. Ludwig David S. Ludwig David S. Ludwig Matthias B. Schulze Matthias B. Schulze Bjoern Erik Ole Jensen Andreas L. Birkenfeld Andreas L. Birkenfeld Andreas L. Birkenfeld |
| author_facet | Norbert Stefan Norbert Stefan Norbert Stefan Katrin Sippel Katrin Sippel Katrin Sippel Martin Heni Martin Heni Martin Heni Andreas Fritsche Andreas Fritsche Andreas Fritsche Robert Wagner Robert Wagner Robert Wagner Carolin E. M. Jakob Carolin E. M. Jakob Hubert Preißl Hubert Preißl Alexander von Werder Alexander von Werder Yascha Khodamoradi Stefan Borgmann Maria Madeleine Rüthrich Frank Hanses Martina Haselberger Christiane Piepel Martin Hower Jürgen vom Dahl Kai Wille Christoph Römmele Janne Vehreschild Janne Vehreschild Janne Vehreschild Melanie Stecher Melanie Stecher Michele Solimena Michele Solimena Michael Roden Michael Roden Michael Roden Annette Schürmann Annette Schürmann Baptist Gallwitz Martin Hrabe de Angelis Martin Hrabe de Angelis Martin Hrabe de Angelis David S. Ludwig David S. Ludwig David S. Ludwig Matthias B. Schulze Matthias B. Schulze Bjoern Erik Ole Jensen Andreas L. Birkenfeld Andreas L. Birkenfeld Andreas L. Birkenfeld |
| author_sort | Norbert Stefan |
| collection | DOAJ |
| description | Advanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021. A total of 3,163 patients with SARS-COV-2 diagnosis in the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort were studied. LEOSS is a European non-interventional multi-center cohort study established in March 2020 to investigate the epidemiology and clinical course of SARS-CoV-2 infection. Data from hospitalized patients and those who received ambulatory care, with a positive SARS-CoV-2 test, were included in the study. An additive effect of obesity, diabetes and hypertension on the risk of mortality was observed, which was particularly strong in young and middle-aged patients. Compared to young and middle-aged (18–55 years) patients without obesity, diabetes and hypertension (non-obese and metabolically healthy; n = 593), young and middle-aged adult patients with all three risk parameters (obese and metabolically unhealthy; n = 31) had a similar adjusted increased risk of mortality [OR 7.42 (95% CI 1.55–27.3)] as older (56–75 years) non-obese and metabolically healthy patients [n = 339; OR 8.21 (95% CI 4.10–18.3)]. Furthermore, increased CRP levels explained part of the elevated risk of COVID-19-related mortality with age, specifically in the absence of obesity and impaired metabolic health. In conclusion, the modifiable risk factors obesity, diabetes and hypertension increase the risk of COVID-19-related mortality in young and middle-aged patients to the level of risk observed in advanced age. |
| first_indexed | 2024-12-12T05:23:57Z |
| format | Article |
| id | doaj.art-f99d511553474728bf4cf86f386a4ed5 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-12T05:23:57Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-f99d511553474728bf4cf86f386a4ed52022-12-22T00:36:33ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-05-01910.3389/fmed.2022.875430875430Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS RegistryNorbert Stefan0Norbert Stefan1Norbert Stefan2Katrin Sippel3Katrin Sippel4Katrin Sippel5Martin Heni6Martin Heni7Martin Heni8Andreas Fritsche9Andreas Fritsche10Andreas Fritsche11Robert Wagner12Robert Wagner13Robert Wagner14Carolin E. M. Jakob15Carolin E. M. Jakob16Hubert Preißl17Hubert Preißl18Alexander von Werder19Alexander von Werder20Yascha Khodamoradi21Stefan Borgmann22Maria Madeleine Rüthrich23Frank Hanses24Martina Haselberger25Christiane Piepel26Martin Hower27Jürgen vom Dahl28Kai Wille29Christoph Römmele30Janne Vehreschild31Janne Vehreschild32Janne Vehreschild33Melanie Stecher34Melanie Stecher35Michele Solimena36Michele Solimena37Michael Roden38Michael Roden39Michael Roden40Annette Schürmann41Annette Schürmann42Baptist Gallwitz43Martin Hrabe de Angelis44Martin Hrabe de Angelis45Martin Hrabe de Angelis46David S. Ludwig47David S. Ludwig48David S. Ludwig49Matthias B. Schulze50Matthias B. Schulze51Bjoern Erik Ole Jensen52Andreas L. Birkenfeld53Andreas L. Birkenfeld54Andreas L. Birkenfeld55Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyInstitute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyInstitute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyInstitute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyInstitute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyDepartment of Internal Medicine I, Faculty of Medicine, University Hospital Cologne, Cologne, University of Cologne, Cologne, GermanyGerman Center for Infection Research (DZIF), Partner-Site Bonn-Cologne, Cologne, GermanyInstitute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyGerman Center for Infection Research (DZIF), Partner-Site Bonn-Cologne, Cologne, GermanyDepartment of Internal Medicine II, School of Medicine, University Hospital Rechts der Isar, Technical University of Munich, Munich, GermanyDepartment of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, GermanyDepartment of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, GermanyDepartment of Internal Medicine II, University Hospital Jena, Jena, Germany0Emergency Department, University Hospital Regensburg, Regensburg, Germany1Department of Internal Medicine I, Passau Hospital, Passau, Germany2Department of Internal Medicine I, Hospital Bremen-Center, Bremen, Germany3Department for Pneumology, Infectiology, Internal Medicine and Intensive Care, gGmbH, Dortmund, Germany4Division of Cardiology, Hospital Maria Hilf Mönchengladbach, Mönchengladbach, Germany5University Clinic for Hematology, Oncology, Hemostaseology and Palliative Care, University of Bochum, Minden, Germany6Internal Medicine III - Gastroenterology and Infectious Diseases, University Hospital of Augsburg, Augsburg, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyDepartment of Internal Medicine I, Faculty of Medicine, University Hospital Cologne, Cologne, University of Cologne, Cologne, Germany7Department of Internal Medicine, Hematology and Oncology, University Hospital Cologne, Goethe University Frankfurt, Frankfurt am Main, GermanyDepartment of Internal Medicine I, Faculty of Medicine, University Hospital Cologne, Cologne, University of Cologne, Cologne, GermanyGerman Center for Infection Research (DZIF), Partner-Site Bonn-Cologne, Cologne, GermanyGerman Center for Diabetes Research (DZD), Munich, Germany8Helmholtz Center Munich, Faculty of Medicine, Paul Langerhans Institute Dresden, University Hospital, Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyGerman Center for Diabetes Research (DZD), Munich, Germany9Department of Endocrinology and Diabetology, Medical Faculty and University Hospital, Heinrich-Heine University, Düsseldorf, Germany0Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich- Heine University, Düsseldorf, GermanyGerman Center for Diabetes Research (DZD), Munich, Germany1Department of Experimental Diabetology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, Germany2Institute of Experimental Genetics, Helmholtz Zentrum München, Oberschleißheim, Germany3TUM School of Life Sciences (SoLS), Chair of Experimental Genetics, Technische Universität München, Freising, Germany4New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, United States5Department of Pediatrics, Harvard Medical School, Boston, MA, United States6Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United StatesGerman Center for Diabetes Research (DZD), Munich, Germany7Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany8Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, GermanyInstitute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich, Tübingen, GermanyDepartment of Internal Medicine IV, University Hospital of Tübingen, Tübingen, GermanyGerman Center for Diabetes Research (DZD), Munich, GermanyAdvanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021. A total of 3,163 patients with SARS-COV-2 diagnosis in the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort were studied. LEOSS is a European non-interventional multi-center cohort study established in March 2020 to investigate the epidemiology and clinical course of SARS-CoV-2 infection. Data from hospitalized patients and those who received ambulatory care, with a positive SARS-CoV-2 test, were included in the study. An additive effect of obesity, diabetes and hypertension on the risk of mortality was observed, which was particularly strong in young and middle-aged patients. Compared to young and middle-aged (18–55 years) patients without obesity, diabetes and hypertension (non-obese and metabolically healthy; n = 593), young and middle-aged adult patients with all three risk parameters (obese and metabolically unhealthy; n = 31) had a similar adjusted increased risk of mortality [OR 7.42 (95% CI 1.55–27.3)] as older (56–75 years) non-obese and metabolically healthy patients [n = 339; OR 8.21 (95% CI 4.10–18.3)]. Furthermore, increased CRP levels explained part of the elevated risk of COVID-19-related mortality with age, specifically in the absence of obesity and impaired metabolic health. In conclusion, the modifiable risk factors obesity, diabetes and hypertension increase the risk of COVID-19-related mortality in young and middle-aged patients to the level of risk observed in advanced age.https://www.frontiersin.org/articles/10.3389/fmed.2022.875430/fullobesitydiabeteshypertensionimpaired metabolic healthmortalityCOVID-19 |
| spellingShingle | Norbert Stefan Norbert Stefan Norbert Stefan Katrin Sippel Katrin Sippel Katrin Sippel Martin Heni Martin Heni Martin Heni Andreas Fritsche Andreas Fritsche Andreas Fritsche Robert Wagner Robert Wagner Robert Wagner Carolin E. M. Jakob Carolin E. M. Jakob Hubert Preißl Hubert Preißl Alexander von Werder Alexander von Werder Yascha Khodamoradi Stefan Borgmann Maria Madeleine Rüthrich Frank Hanses Martina Haselberger Christiane Piepel Martin Hower Jürgen vom Dahl Kai Wille Christoph Römmele Janne Vehreschild Janne Vehreschild Janne Vehreschild Melanie Stecher Melanie Stecher Michele Solimena Michele Solimena Michael Roden Michael Roden Michael Roden Annette Schürmann Annette Schürmann Baptist Gallwitz Martin Hrabe de Angelis Martin Hrabe de Angelis Martin Hrabe de Angelis David S. Ludwig David S. Ludwig David S. Ludwig Matthias B. Schulze Matthias B. Schulze Bjoern Erik Ole Jensen Andreas L. Birkenfeld Andreas L. Birkenfeld Andreas L. Birkenfeld Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry Frontiers in Medicine obesity diabetes hypertension impaired metabolic health mortality COVID-19 |
| title | Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry |
| title_full | Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry |
| title_fullStr | Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry |
| title_full_unstemmed | Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry |
| title_short | Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry |
| title_sort | obesity and impaired metabolic health increase risk of covid 19 related mortality in young and middle aged adults to the level observed in older people the leoss registry |
| topic | obesity diabetes hypertension impaired metabolic health mortality COVID-19 |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.875430/full |
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