Characteristics and outcomes of 627 044 COVID-19 patients living with and without obesity in the United States, Spain, and the United Kingdom

Martina Recalde, Elena Roel, Andrea Pistillo, Anthony G. Sena, Albert Prats-Uribe, Waheed Ul Rahman Ahmed, Heba Alghoul, Thamir M. Alshammari, Osaid Alser, Carlos Areia, Edward Burn, Paula Casajust, Dalia Dawoud, Scott L. DuVall, Thomas Falconer, Sergio Fernández-Bertolín, Asieh Golozar, Mengchun Gong, Lana Yin Hui Lai, Jennifer C.E. LaneKristine E. Lynch, Michael E. Matheny, Paras P. Mehta, Daniel R. Morales, Karthik Natarjan, Fredrik Nyberg, Jose D. Posada, Christian G. Reich, Peter R. Rijnbeek, Lisa M. Schilling, Karishma Shah, Nigam H. Shah, Vignesh Subbian, Lin Zhang, Hong Zhu, Patrick Ryan, Daniel Prieto-Alhambra, Kristin Kostka, Talita Duarte-Salles*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)
23 Downloads (Pure)


Background: A detailed characterization of patients with COVID-19 living with obesity has not yet been undertaken. We aimed to describe and compare the demographics, medical conditions, and outcomes of COVID-19 patients living with obesity (PLWO) to those of patients living without obesity. Methods: We conducted a cohort study based on outpatient/inpatient care and claims data from January to June 2020 from Spain, the UK, and the US. We used six databases standardized to the OMOP common data model. We defined two non-mutually exclusive cohorts of patients diagnosed and/or hospitalized with COVID-19; patients were followed from index date to 30 days or death. We report the frequency of demographics, prior medical conditions, and 30-days outcomes (hospitalization, events, and death) by obesity status. Results: We included 627 044 (Spain: 122 058, UK: 2336, and US: 502 650) diagnosed and 160 013 (Spain: 18 197, US: 141 816) hospitalized patients with COVID-19. The prevalence of obesity was higher among patients hospitalized (39.9%, 95%CI: 39.8−40.0) than among those diagnosed with COVID-19 (33.1%; 95%CI: 33.0−33.2). In both cohorts, PLWO were more often female. Hospitalized PLWO were younger than patients without obesity. Overall, COVID-19 PLWO were more likely to have prior medical conditions, present with cardiovascular and respiratory events during hospitalization, or require intensive services compared to COVID-19 patients without obesity. Conclusion: We show that PLWO differ from patients without obesity in a wide range of medical conditions and present with more severe forms of COVID-19, with higher hospitalization rates and intensive services requirements. These findings can help guiding preventive strategies of COVID-19 infection and complications and generating hypotheses for causal inference studies.

Original languageEnglish
Pages (from-to)2347-2357
Number of pages11
JournalInternational Journal of Obesity
Issue number11
Early online date15 Jul 2021
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
The European Health Data & Evidence Network has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 806968. The JU receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA. This research received partial support from the National Institute for Health Research (NIHR) Oxford Biomedical Research Center (BRC), US National Institutes of Health, US Department of Veterans Affairs, Janssen Research & Development, and IQVIA. The University of Oxford received funding related to this work from the Bill & Melinda Gates Foundation (Investment ID INV-016201 and INV-019257). APU has received funding from the Medical Research Council (MRC) [MR/K501256/1, MR/N013468/1] and Fundación Alfonso Martín Escudero (FAME) (APU). VINCI [VA HSR RES 13-457] (SLD, MEM, KEL). JCEL has received funding from the Medical Research Council (MR/K501256/1) and Versus Arthritis (21605). MR is funded by Wereld Kanker Onderzoek Fonds (WKOF), as part of the World Cancer Research Fund International grant program [grant number: 2017/ 1630]. No funders had a direct role in this study. The views and opinions expressed are those of the authors and do not necessarily reflect those of the Clinician Scientist Award program, NIHR, Department of Veterans Affairs or the United States Government, NHS, or the Department of Health, England.

Funding Information:
All authors have completed the ICMJE uniform disclosure form at coi_disclosure.pdf and declare: Mr. Sena reports personal fees from Janssen Research & Development, outside the submitted work; Dr. DuVall reports grants from Anolinx, LLC, grants from Astellas Pharma, Inc, grants from AstraZeneca Pharmaceuticals LP, grants from Boehringer Ingelheim International GmbH, grants from Celgene Corporation, grants from Eli Lilly and Company, grants from Genentech Inc., grants from Genomic Health, Inc., grants from Gilead Sciences Inc., grants from GlaxoSmithKline PLC, grants from Innocrin Pharmaceuticals Inc., grants from Janssen Pharmaceuticals, Inc., grants from Kantar Health, grants from Myriad Genetic Laboratories, Inc., grants from Novartis International AG, grants from Parexel International Corporation through the University of Utah or Western Institute for Biomedical Research, outside the submitted work; Mr Ahmed reports funding from the NIHR Oxford Biomedical Research Center (BRC), Aziz Foundation, Wolfson Foundation, and the Royal College Surgeons of England; Dr. Golozar reports personal fees from Regeneron Pharmaceuticals, outside the submitted work. She is a full-time employee at Regeneron Pharmaceuticals. This work was not conducted at Regeneron Pharmaceuticals. Miss Lane is supported by a Medical Research Council Doctoral Research Fellowship (MR/K501256/1) and a Versus Arthritis Clinical Research Fellowship (21605). Dr. Morales is supported by a Wellcome Trust Clinical Research Development Fellowship (Grant 214588/Z/18/Z) and reports grants from Chief Scientist Office (CSO), grants from Health Data Research UK (HDR-UK), grants from National Institute of Health Research (NIHR), outside the submitted work; Dr. Nyberg reports other from AstraZeneca, outside the submitted work; Dr. Subbian reports grants from National Science Foundation, grants from State of Arizona; Arizona Board of Regents, grants from Agency for Healthcare Research and Quality, outside the submitted work; Dr Prieto-Alhambra reports grants and other from AMGEN; grants, non-financial support and other from UCB Biopharma; grants from Les Laboratoires Servier, outside the submitted work; and Janssen, on behalf of IMI-funded EHDEN and EMIF consortiums, and Synapse Management Partners have supported training programs organized by DPA’s department and open for external participants. Ms. Kostka and Dr. Reich report being employees of IQVIA Inc at the time the analysis was conducted. Dr. Rijnbeek reports grants from Innovative Medicines Initiative, grants from Janssen Research and Development, during the conduct of the study. Dr. Ryan is an employee of Janssen Research and Development and shareholder of Johnson & Johnson. The views expressed are those of the authors and do not necessarily represent the views or policy of the Department of Veterans Affairs or the United States Government. No other relationships or activities that could appear to have influenced the submitted work.

Publisher Copyright:
© 2021, The Author(s).


Dive into the research topics of 'Characteristics and outcomes of 627 044 COVID-19 patients living with and without obesity in the United States, Spain, and the United Kingdom'. Together they form a unique fingerprint.

Cite this