J Korean Diabetes.  2021 Sep;22(3):174-178. 10.4093/jkd.2021.22.3.174.

Diabetes, Obesity, and COVID-19

• Rhee SY

• KMID: 2526197
• DOI: http://doi.org/10.4093/jkd.2021.22.3.174

Abstract

Studies have reported that people with chronic diseases such as diabetes and obesity have a higher risk of coronavirus disease 2019 (COVID-19) infection than does the general population and are associated with poor prognosis. As a number of research results have been published, our understanding of COVID-19 infection is deepening. In this article, I would like to summarize and introduce clinical considerations for COVID-19 infection in people with diabetes and/or obesity based on the results of major studies published to date.

Keyword

COVID-19; Diabetes mellitus; Obesity

Reference

1. Lim S, Bae JH, Kwon HS, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management. Nat Rev Endocrinol. 2021; 17:11–30.

2. Lim S, Shin SM, Nam GE, Jung CH, Koo BK. Proper management of people with obesity during the COVID-19 pandemic. J Obes Metab Syndr. 2020; 29:84–98.

3. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395:1054–62.

4. Guo W, Li M, Dong Y, Zhou H, Zhang Z, Tian C, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. 2020; 36:e3319.

5. Bode B, Garrett V, Messler J, McFarland R, Crowe J, Booth R, et al. Glycemic characteristics and clinical outcomes of COVID-19 patients hospitalized in the United States. J Diabetes Sci Technol. 2020; 14:813–21.

6. Barron E, Bakhai C, Kar P, Weaver A, Bradley D, Ismail H, et al. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Lancet Diabetes Endocrinol. 2020; 8:813–22.

7. Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323:1239–42.

8. Moon SJ, Rhee EJ, Jung JH, Han KD, Kim SR, Lee WY, et al. Independent impact of diabetes on the severity of Coronavirus disease 2019 in 5,307 patients in South Korea: a nationwide cohort study. Diabetes Metab J. 2020; 44:737–46.

9. Riddle MC, Buse JB, Franks PW, Knowler WC, Ratner RE, Selvin E, et al. COVID-19 in people with diabetes: urgently needed lessons from early reports. Diabetes Care. 2020; 43:1378–81.

10. Holman N, Knighton P, Kar P, O'Keefe J, Curley M, Weaver A, et al. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. Lancet Diabetes Endocrinol. 2020; 8:823–33.

11. Cariou B, Hadjadj S, Wargny M, Pichelin M, Al-Salameh A, Allix I, et al. CORONADO investigators. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020; 63:1500–15.

12. Kwong JC, Campitelli MA, Rosella LC. Obesity and respiratory hospitalizations during influenza seasons in Ontario, Canada: a cohort study. Clin Infect Dis. 2011; 53:413–21.

13. Karki S, Muscatello DJ, Banks E, MacIntyre CR, McIntyre P, Liu B. Association between body mass index and laboratory-confirmed influenza in middle aged and older adults: a prospective cohort study. Int J Obes (Lond). 2018; 42:1480–8.

14. Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008; 359:2105–20.

15. Price GM, Uauy R, Breeze E, Bulpitt CJ, Fletcher AE. Weight, shape, and mortality risk in older persons: elevated waist-hip ratio, not high body mass index, is associated with a greater risk of death. Am J Clin Nutr. 2006; 84:449–60.

16. Prospective Studies Collaboration. Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009; 373:1083–96.

17. Caussy C, Pattou F, Wallet F, Simon C, Chalopin S, Telliam C, et al. COVID Outcomes HCL Consortium and Lille COVID–Obesity Study Group. Prevalence of obesity among adult inpatients with COVID-19 in France. Lancet Diabetes Endocrinol. 2020; 8:562–4.

18. Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, et al. Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission. Clin Infect Dis. 2020; 71:896–7.

19. Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al. LICORN and the Lille COVID-19 and Obesity study group. High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity (Silver Spring). 2020; 28:1195–9.

20. Anderson MR, Geleris J, Anderson DR, Zucker J, Nobel YR, Freedberg D, et al. Body mass index and risk for intubation or death in SARS-CoV-2 infection: a retrospective cohort study. Ann Intern Med. 2020; 173:782–90.

21. Tartof SY, Qian L, Hong V, Wei R, Nadjafi RF, Fischer H, et al. Obesity and mortality among patients diagnosed with COVID-19: results from an integrated health care organization. Ann Intern Med. 2020; 173:773–81.

22. Jung CY, Park H, Kim DW, Lim H, Chang JH, Choi YJ, et al. Association between body mass index and risk of COVID-19: a nationwide case-control study in South Korea. Clin Infect Dis. 2020. doi: 10.1093/cid/ciaa1257. [Epub ahead of print].

23. Popkin BM, Du S, Green WD, Beck MA, Algaith T, Herbst CH, et al. Individuals with obesity and COVID-19: a global perspective on the epidemiology and biological relationships. Obes Rev. 2020; 21:e13128.

24. Kirkman MS, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in older adults. Diabetes Care. 2012; 35:2650–64.

25. Jura M, Kozak LP. Obesity and related consequences to ageing. Age (Dordr). 2016; 38:23.

26. Woods JA, Wilund KR, Martin SA, Kistler BM. Exercise, inflammation and aging. Aging Dis. 2012; 3:130–40.

27. Galland L. Diet and inflammation. Nutr Clin Pract. 2010; 25:634–40.

28. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002; 346:393–403.

29. Rhee SY, Lee J, Nam H, Kyoung DS, Shin DW, Kim DJ. Effects of a DPP-4 inhibitor and RAS blockade on clinical outcomes of patients with diabetes and COVID-19. Diabetes Metab J. 2021; 45:251–9.

30. Lee HY, Ahn J, Park J, Kang CK, Won SH, Kim DW, et al. Korean Society of Hypertension, National Committee for Clinical Management of Emerging Infectious Diseases. Beneficial effect of statins in COVID-19-related outcomes-brief report: a national population-based cohort study. Arterioscler Thromb Vasc Biol. 2021; 41:e175–82.

31. Crouse AB, Grimes T, Li P, Might M, Ovalle F, Shalev A. Metformin use is associated with reduced mortality in a diverse population with COVID-19 and diabetes. Front Endocrinol (Lausanne). 2021; 11:600439.

32. Yang Y, Cai Z, Zhang J. DPP-4 inhibitors may improve the mortality of Coronavirus disease 2019: a meta-analysis. PLoS One. 2021; 16:e0251916.

33. Solerte SB, D'Addio F, Trevisan R, Lovati E, Rossi A, Pastore I, et al. Sitagliptin treatment at the time of hospitalization was associated with reduced mortality in patients with type 2 diabetes and COVID-19: a multicenter, case-control, retrospective, observational study. Diabetes Care. 2020; 43:2999–3006.