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

ISARIC4C Investigators, Thomas Yates*, Francesco Zaccardi, Nazrul Islam, Cameron Razieh, Clare L. Gillies, Claire A. Lawson, Yogini Chudasama, Alex Rowlands, Melanie J. Davies, Annemarie B. Docherty, Peter J.M. Openshaw, J. Kenneth Baillie, Malcolm G. Semple, Kamlesh Khunti, Meera Chand-Kumar, William Dunning

*Corresponding author for this work

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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.

Original languageEnglish
Pages (from-to)1223-1230
Number of pages8
JournalObesity
Volume29
Issue number7
Early online date14 May 2021
DOIs
Publication statusPublished - 23 Jun 2021

Bibliographical note

Funding Information: This work was supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), NIHR Applied Research Collaboration East Midlands (ARC EM), and a grant from the UK Research and Innovation ‐ Department of Health and Social Care (UKRI‐DHSC) COVID‐19 Rapid Response Rolling Call (MR/V020536/1 to TY); NIHR (award CO‐CIN‐01 to MGS); the Medical Research Council (MRC; grant MC_PC_19059 to MGS); and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool. The funder/sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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.

Open Access: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © 2021 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society (TOS).

Citation: Yates, T., Zaccardi, F., Islam, N., Razieh, C., Gillies, C.L., Lawson, C.A., Chudasama, Y., Rowlands, A., Davies, M.J., Docherty, A.B., Openshaw, P.J.M., Baillie, J.K., Semple, M.G., and Khunti, K. (2021), 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. Obesity, 29: 1223-1230.

DOI: https://doi.org/10.1002/oby.23178

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