Global association of obesity and COVID-19 death rates

Importance

COVID-19 was responsible for an enormous global death toll with large variation among countries.

Objective

To examine the possible impact of obesity on COVID-19 death rates.

Design

Measure associations between obesity rates in 2016 and COVID-19 deaths/million population through 2/25/2021, across countries.

Setting

Global

Participants

167 countries for which obesity and death data were available, grouped by population size, with multiples of 10 countries in each of 8 groups plus a group including all 57 countries with obesity rates <15%.

Outcome and measures

Using Excel, COVID-19 deaths/million were regressed on the obesity rate for each country, based on obesity being a key factor in COVID hospitalizations and deaths. Using the least squares formula for the best fit for each model, R ² , components of the formula, and the percentage of world population represented, were recorded for each group.

Results

Obesity rates ranged from 2.1% to 37.9% and death rates ranged from 0.4/million to 1,892/million for groups representing up to 91% of global population. Results for the 8 population groups had R ² from 0.30 to 0.90 with slopes of the fitted line ranging from 27.9-51.0. Countries with obesity rates <15% had consistently low death rates (≤233/million), R ² of 0.003 and slope of the line=1.01.

Conclusions

For most countries about one-third of the difference in COVID death rates was due to obesity while in countries with obesity <15%, consistently low death rates were not associated with obesity. Reduced obesity rates could potentially have lowered the COVID death toll.