Diabesity Associates with Poor COVID-19 Outcomes among Hospitalized Patients

BACKGROUND: Although numerous studies have investigated obesity’s negative effect on coronavirus disease 2019 (COVID-19) outcomes, only a limited number focused on this association in diabetic patients. In this study, we analyzed the association between obesity and COVID-19 outcome (death, intensive care unit [ICU] admission, mechanical ventilation needs, quick Sequential Organ Failure Assessment [qSOFA] score, and confusion, urea, respiratory rate, blood pressure [CURB-65] scores) for hospitalized diabetic patients. METHODS: In this prospective hospital-based registry of patients with COVID-19 in East Azerbaijan, Iran, 368 consecutive diabetic patients with COVID-19 were followed from admission until discharge or death. Self-reported weight and height were used to calculate body mass index (kg/m(2)) upon admission. Our primary endpoint was analyzing obesity and COVID-19 mortality association. Assessing the associations among obesity and disease severity, ICU admission, and mechanical ventilation was our secondary endpoint. RESULTS: We analyzed data from 317 patients and found no significant difference between obese and non-obese patients regarding frequency of death, invasive mechanical ventilation, ICU admission, CURB-65, or qSOFA scores (P>0.05). After adjusting for confounding factors, obese diabetic COVID-19 patients were 2.72 times more likely to die than non-obese patients. Moreover, ventilator dependence (adjusted odds ratio [aOR], 1.87; 95% confidence interval [CI], 1.03–4.76) and ICU admission (aOR, 2.41; 95% CI, 1.11–5.68) odds were significantly higher for obese patients than non-obese patients. CONCLUSION: The results of the present study indicated that obesity worsens health outcomes for diabetic COVID-19 patients.