Katsoulis, M;
Pasea, L;
Lai, AG;
Dobson, RJB;
Denaxas, S;
Hemingway, H;
Banerjee, A;
(2021)
Obesity during the COVID-19 pandemic: both cause of high risk and potential effect of lockdown? A population-based electronic health record study.
Public Health
, 191
pp. 41-47.
10.1016/j.puhe.2020.12.003.
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Abstract
Objectives: Obesity is a modifiable risk factor for coronavirus(COVID-19)-related mortality. We estimated excess mortality in obesity, both “direct”, through infection, and “indirect”, through changes in healthcare, and also due to potential increasing obesity during lockdown. / Study design: Retrospective cohort study and causal inference methods. / Methods: In population-based electronic health records for 1 958 638 individuals in England, we estimated 1-year mortality risk(“direct” and “indirect” effects) for obese individuals, incorporating: (i)pre-COVID-19 risk by age, sex and comorbidities, (ii)population infection rate, and (iii)relative impact on mortality(relative risk, RR: 1.2, 1.5, 2.0 and 3.0). Using causal inference models, we estimated impact of change in body-mass index(BMI) and physical activity during 3-month lockdown on 1-year incidence for high-risk conditions(cardiovascular diseases, CVD; diabetes; chronic obstructive pulmonary disease, COPD and chronic kidney disease, CKD), accounting for confounders. / Results: For severely obese individuals (3.5% at baseline), at 10% population infection rate, we estimated direct impact of 240 and 479 excess deaths in England at RR 1.5 and 2.0 respectively, and indirect effect of 383 to 767 excess deaths, assuming 40% and 80% will be affected at RR=1.2. Due to BMI change during the lockdown, we estimated that 97 755 (5.4%: normal weight to overweight, 5.0%: overweight to obese and 1.3%: obese to severely obese) to 434 104 individuals (15%: normal weight to overweight, 15%: overweight to obese and 6%: obese to severely obese) individuals would be at higher risk for COVID-19 over one year. / Conclusion: Prevention of obesity and promotion of physical activity are at least as important as physical isolation of severely obese individuals during the pandemic.
| Type: | Article |
|---|---|
| Title: | Obesity during the COVID-19 pandemic: both cause of high risk and potential effect of lockdown? A population-based electronic health record study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.puhe.2020.12.003 |
| Publisher version: | https://doi.org/10.1016/j.puhe.2020.12.003 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | obesity, coronavirus, physical activity, cardiovascular, diabetes |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics > Clinical Epidemiology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10118062 |
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