A high body mass index (BMI), instead of high blood sugar levels, are associated with an increased risk of COVID-19 infection, as well as long COVID, according to the results of a study published at the European Association for the Study of Diabetes Annual Meeting in Stockholm, Sweden.
“Early in the pandemic, research identified diabetes and obesity as risk factors for becoming severely ill with COVID-19, and we know that many [individuals] 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,” Anika Knüppel, PhD, from the MRC Unit for Lifelong Health and Ageing at the University College London in the United Kingdom, said in a statement.
Other research has shown that individuals with diabetes and obesity are more likely to become ill and die, because of a COVID-19 infection but are not more likely to contract it.
Investigators of the latest study wanted to determine the associations between a range of clinical characteristics measured before the pandemic, including BMI, HbA1c, medication-based or self-reported diabetes, self-reported COVID-19 infection and long COVID, and waist-to-hip ratio .
The analyses, from 9 ongoing United Kingdom cohort studies, included the most recent measurements that were taken between 2002 and 2019, such as HbA1c, height, hip and waist circumference, and weight. Investigators also collected information from questionnaires on health and lifestyle.
All individuals had data on previous measurements and completed at least 1 questionnaire during the COVID-1 pandemic from May 2020 to September 2021, which covered questions about the disease and questions on the length of ongoing related symptoms.
The individuals reported having COVID-19 based on a positive test or strong suspicion, and long COVID was defined as symptoms that continued for longer than 4 weeks after an infection. The long COVID symptoms were compared with those reported for less than 4 weeks.
Investigators adjusted for education, ethnicity, income, sex, and smoking at the time of measurement when necessary.
Between May 2020 and September 2021, 5806 individuals reported having COVID-19 and 584 reported having long COVID.
The results from the analysis of data, including 31,252 individuals in 9 studies, showed that higher BMI was associated with greater odds of COVID-19 infection, with the risk of 7% higher for each 5kg/m2 increase in BMI.
Additionally, individuals who were obese or overweight had 16% and 10% greater odds of COVID-19 infection, respectively, than individuals who were not obese or overweight.
Investigators saw comparable results for those with long COVID, including 423 individuals from 6 studies. The risk was 20% higher for each 5kg/m2 increase in BMI. Individuals who were obese or overweight had 36% and 20% greater odds of long COVID, respectively.
Investigators reported that both COVID-19 infection and long COVID associated with categories of BMI were not all statistically significant.
Studies that focused on average HbA1c and diabetes had no association with COVID-19 or long COVID, they said.
Further research is needed to explore the mechanisms of these associations and to reduce the risk associated with high BMI, investigators said.
Excess weight, not high blood sugar, associated with increased risk of COVID-19 infection and long COVID. News release. EurekAlert. September 16, 2022. Accessed September 22, 2022. https://www.eurekalert.org/news-releases/964905