Excess weight, not high blood sugar, associated with increased risk of COVID-19 infection and long COVID
High body mass index (BMI), rather than high blood sugar levels, are associated with excess risks of COVID-19 infection and long COVID, according to a meta-analysis of over 30,000 UK adults from nine large prospective cohort studies.
The findings by Dr Anika Knuppel from the MRC Unit for Lifelong Health and Ageing, University College London, UK, and colleagues presented at this year's European Association for the Study of Diabetes (EASD) Annual Meeting in Stockholm, Sweden (19-23 Sept).
"Early in the pandemic research identified diabetes and obesity as risk factors for becoming severely ill with COVID-19. And we know that many people living with type 2 diabetes are also carrying excess weight. Our early findings support the idea that obesity-related mechanisms may be responsible for the excess risks of COVID-19 associated with diabetes, rather than high blood sugar per se," says Dr Knuppel.
Previous research showed that people with diabetes and obesity are more likely to become severely ill and die if they catch COVID-19. To find out more, researchers looked for associations between a range of clinical characteristics measured before the pandemic—HbA1c (average blood sugar level), self-reported or medication-based diabetes, body mass index (BMI) and waist-to-hip ratio (WHR)—and self-reported COVID-19 infection and long COVID in nine ongoing UK cohort studies.
Analysis of data from 31,252 participants in nine studies found higher BMI was associated with greater odds of COVID-19 infection—with the risk 7% higher for each 5 kg/m2 increase in BMI. People with overweight (BMI 25-29.9 kg/m2) and obesity (30 kg/m2 or greater) had 10% and 16% greater odds of COVID-19 infection, respectively, than healthy weight individuals (less than 25 kg/m2).
Similar results were observed for long COVID (4,243 participants, six studies)—with the risk 20% higher for each 5 kg/m2 increase in BMI. People with overweight and obesity had 20% and 36% greater odds of long COVID, respectively. However, for both COVID infection and long COVID associations with categories of BMI were not all statistically significant.
Notably, studies focusing on average blood sugar level (HbA1c) and diabetes (15,795 participants and 1,917 for long COVID) revealed no association with COVID-19 or long-COVID.
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