Clinical, Immunological, and Virological SARS-CoV-2 Phenotypes in Obese and Nonobese Military Health System Beneficiaries
Author:
Epsi Nusrat J12, Richard Stephanie A12, Laing Eric D3, Fries Anthony C4, Millar Eugene12, Simons Mark P1, English Caroline12, Colombo Christopher J56, Colombo Rhonda E125, Lindholm David A7, Ganesan Anuradha128, Maves Ryan C9, Huprikar Nikhil8, Larson Derek10, Mende Katrin127, Chi Sharon W1211, Madar Cristian11, Lalani Tahaniyat1212ORCID, Broder Christopher C3, Tribble David1, Agan Brian K12ORCID, Burgess Timothy H1, Pollett Simon D12, Cowden J, Lindholm D, Markelz A, Mende K, Merritt T, Walter R, Wellington T, Darnall Carl R, Bazan S, Brandon L, Dimascio-Johnson N, Gallagher K, Larson D, Jackson Henry M, Blair P, Clark D, Chambers S, Colombo C, Colombo R, Conlon C, Everson K, Faestel P, Ferguson T, Gordon L, Grogan S, Lis S, Mount C, Musfeldt D, Sainato R, Schofield C, Skinner C, Stein M, Switzer M, Timlin M, Wood S, Atwood G, Carpenter R, Eickhoff C, Kronmann K, Lalani T, Lee T, Warkentien T, Arnold J, Berjohn C, Cammarata S, Husain S, Kirkland N, Lane A, Maves R, Parrish J, Utz G, Chi S, Filan E, Fong K, Horseman T, Jones M, Kanis A, Kayatani A, Londeree W, Madar C, Masel J, McMahon M, Murphy G, Ngauy V, Schoenman E, Uyehara C, Villacorta Lyew R, Agan B, Broder C, Burgess T, Byrne C, Chung K, Coles C, English C, Hickey P, Laing E, Livezey J, Malloy A, Oliver T, Parmelee E, Pollett S, Richard S, Rozman J, Rusiecki J, Sanchez M, Scher A, Simons M, Snow A, Tribble D, Fries A, Ganesan A, Gunasekera D, Huprikar N, Oyeneyin M, Banda M, Davis B, Hunter T, Ikpekpe-Magege O, Kemp S, Mody R, Resendez R, Wiggins M,
Affiliation:
1. Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA 2. Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA 3. Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA 4. US Air Force School of Aerospace Medicine, Dayton, Ohio, USA 5. Madigan Army Medical Center, Joint Base Lewis McChord, Tacoma, Washington, USA 6. Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA 7. Brooke Army Medical Center, Fort Sam Houston, Texas, USA 8. Walter Reed National Military Medical Center, Bethesda, Maryland, USA 9. Naval Medical Center San Diego, San Diego, California, USA 10. Fort Belvoir Community Hospital, Fort Belvoir, Virginia, USA 11. Tripler Army Medical Center, Honolulu, Hawaii, USA 12. Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
Abstract
Abstract
Background
The mechanisms underlying the association between obesity and coronavirus disease 2019 (COVID-19) severity remain unclear. After verifying that obesity was a correlate of severe COVID-19 in US Military Health System (MHS) beneficiaries, we compared immunological and virological phenotypes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in both obese and nonobese participants.
Methods
COVID-19–infected MHS beneficiaries were enrolled, and anthropometric, clinical, and demographic data were collected. We compared the SARS-CoV-2 peak IgG humoral response and reverse-transcription polymerase chain reaction viral load in obese and nonobese patients, stratified by hospitalization, utilizing logistic regression models.
Results
Data from 511 COVID-19 patients were analyzed, among whom 24% were obese and 14% severely obese. Obesity was independently associated with hospitalization (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.15–3.18) and need for oxygen therapy (aOR, 3.39; 95% CI, 1.61–7.11). In outpatients, severely obese had a log10 (1.89) higher nucleocapsid (N1) genome equivalents (GE)/reaction and log10 (2.62) higher N2 GE/reaction than nonobese (P = 0.03 and P < .001, respectively). We noted a correlation between body mass index and peak anti-spike protein IgG in inpatients and outpatients (coefficient = 5.48, P < .001).
Conclusions
Obesity is a strong correlate of COVID-19 severity in MHS beneficiaries. These findings offer new pathophysiological insights into the relationship between obesity and COVID-19 severity.
Funder
National Institute of Allergy and Infectious Diseases National Institutes of Health
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Immunology and Allergy
Cited by
13 articles.
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