Obesity, diabetes and high blood pressure increase mortality from COVID-19

Data from the European case register LEOSS

Obesity, impaired blood glucose metabolism, and high blood pressure increase the risk of dying from COVID-19 in young and middle-aged people to a level mostly observed in people of advanced age. This is shown in a recent study* based on data from the Lean European Open Survey for SARS-CoV-2 Infected Patients (LEOSS**).

Elderly people and men have a particularly high risk of developing severe COVID-19 and dying from it1. This is shown by current statistics. Obesity and elevated blood glucose levels are also considered potential risk factors for severe COVID-19. However, the effect of pre-existing conditions on the course of SARS-CoV-2 infection, particularly in younger people, aged between 18 and 55 years, has not yet been adequately studied. To find out whether obesity, diabetes and elevated blood pressure influence the severity of COVID-19 and increase the associated mortality, researchers of the German Center for Diabetes Research (DZD), the IDM (Institute for Diabetes Research and Metabolic Diseases of Helmholtz Munich at the University of Tübingen), and the German Center for Infection Research (DZIF), among other institutions, analyzed data from a total of 3,163 patients with SARS-COV-2 infection from the European case registry LEOSS.

“The results showed that obesity, impaired blood glucose metabolism and high blood pressure have an additive effect on COVID-19-related mortality – especially in young and middle-aged COVID-19 patients," said Professor Norbert Stefan, first author of the study. Furthermore, patients in this age group with all three pre-existing conditions were found to have a similar increased risk of death, as older people (56-75 years), who were metabolically healthy and not obese.

"It is therefore particularly important to intensify the medical monitoring and therapy of younger COVID-19 patients when obesity or diabetes or elevated blood pressure are present," said last author of the study Professor Andreas Birkenfeld, medical director of Medical Clinic IV at the University of Tübingen, head of the Helmholtz Institute in Tübingen and spokesperson of the DZD. Building on their long-standing expertise about the important role of obesity and impaired metabolism in the development of cardiometabolic diseases, both researchers addressed these risks and strategies to mitigate them already early in the course of the COVID-19 pandemic.2,3

*Current publication:
Stefan N, ... Birkenfeld AL. et al.: 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 (2022); DOI: doi.org/10.3389/fmed.2022.875430

**LEOSS – Lean European Open Survey for SARS-CoV-2 Infected Patients:
On the initiative of the German Society of Infectious Diseases (DGI), a European case registry has been launched in collaboration with the German Center for Infection Research (DZIF) to collect clinical data for patients with SARS-CoV-2 infection. LEOSS is a European non-interventional multicenter cohort study. Launched in March 2020, the registry is characterized by the fact that all data collected will go to the scientific community for shared analysis. Among others, the German Centers for Health Research (DZG) are also involved in the registry. The DZD uses the registry, for example, to investigate the influence of obesity and an impaired metabolism on the severity of COVID-19 disease. https://leoss.net/

Previous publications by the authors on this topic:
(1) Journal of Health Monitoring | S2/2021 | Risikogruppen für schwere COVID-19-Verläufe (rki.de)

(2) LEOSS – Lean European Open Survey for SARS-CoV-2 Infected Patients . Further informationen: https://leoss.net/

(3) Stefan N, Birkenfeld AL, Schulze MB, Ludwig DS. Obesity and impaired metabolic health in patients with COVID-19. Nat Rev Endocrinol. 2020 Jul;16(7):341-342.

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