Interesting California COVID-19 mortality study

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Eddy Edson

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Relationship to Diabetes
Type 2

Looking at COVID-19 related deaths across the Kaiser Permanante health system in southern California.

The main focus was on BMI as an independent risk factor - ie independent of ethnicity, commorbidity, social status etc. Conclusion: not really significant except for males <= 60 years old with BMI >= 40, and older males with BMI >= 45.


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Also looked at other associations, with some interesting outcomes:

- *No* significant association with diabetes as an independent factor, regardless of HbA1c.
- In fact the only commorbidites with a significant association were organ transplant and a bit for MI.
- Nothing for ethnicity.
- Strongly reducing morbidity over time, repeating that pattern seen everywhere "likely because of expansion of the COVID-19 testing approach and evolution of hospital-based patient management."

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In summary, we found that obesity was strongly associated with risk for death among our study population of patients with COVID-19. Male and younger patients with high BMI seemed to be at particularly high risk. In our prepaid system with more equalized access to care, we did not detect elevated risk associated with many of the sociodemographic and clinical characteristics seen in prior literature. Although we cannot expect to disassociate the constellations of social and clinical factors that contribute to health disparities and multifactorial chronic conditions in our patients, our data help define the main drivers of adverse outcomes. Principally, we demonstrate the leading role severe obesity has over other highly correlated risk factors, providing a clear target for early intervention. Our findings also reveal the distressing collision of 2 pandemics: COVID-19 and obesity. As COVID-19 continues to spread unabated, we must focus our immediate efforts on containing the crisis at hand. Yet, our findings also underscore the need for future collective efforts to combat the equally devastating, and potentially synergistic, force of the obesity epidemic.
 
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