Key result
A mean country-level BMI below 25 was associated with significantly lower odds of high COVID-19 mortality (OR 0.036) compared to countries with a mean BMI of 25 or higher.
Why the study?
Excessive nutrition may contribute to an unknown portion of COVID-19 deaths, prompting an assessment of host factors like BMI on pandemic mortality.
Does a higher mean country-level BMI correlate with increased COVID-19 mortality rates?
Observational (n=181)
Does a higher mean country-level BMI correlate with increased COVID-19 mortality rates?
Higher country-level mean BMI is strongly associated with increased COVID-19 mortality rates, suggesting a significant impact of excess weight on pandemic outcomes.
Answers are grounded in this paper and cite their sources.
Should not alter clinical practice or policy; leaves open whether individual BMI drives COVID-19 mortality.
Accountability for global health issues such as a pandemic and its devastating consequences are usually ascribed to a virus, but a comprehensive view should also take into account the state of the host. Data suggests that excessive nutrition is to blame for a yet unknown but not negligible portion of deaths attributed to severe acute respiratory syndrome coronavirus 2. We analyzed the correlation between mean body mass index (BMI) and 2-year coronavirus disease 2019 (COVID-19) mortality rates reported by 181 countries worldwide. Almost two thirds of the countries included had a mean BMI greater or equal to 25, with death rates ranging from 3 to 6,280 per million. Death rates in countries with a mean BMI below 25 ranged from 3 to 1,533. When the analysis was restricted to countries where the extent of testing was deemed more representative of actual mortality, only 20.1% had a mean BMI <25 but the mortality difference persisted. A second analysis looking at pre-vaccination mortality obtained from a different source led to similar conclusions. Due to the nature of the variables, reverse causation can be excluded while common causation can not. A mean BMI <25 for a country seems to spare its citizens from the highest COVID-19 mortality rates. The impact of excess weight on global COVID-19 mortality is suspected to have been much higher than what currently perceived, here estimated at no less than a fourfold increase in mortality. Countries with normal mean BMI constitute precious test beds for the quantification of the effects of overeating on COVID-19 mortality.
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Gabbrielli et al. (2023) conducted an observational in COVID-19 (n=181). Mean BMI < 25 vs. Mean BMI ≥ 25 was evaluated on High reported COVID-19 mortality (>720 deaths per 1,000,000 population) (OR 0.036). A mean country-level BMI below 25 was associated with significantly lower odds of high COVID-19 mortality (OR 0.036) compared to countries with a mean BMI of 25 or higher.
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