Association of adiposity and its changes over time with COVID-19 risk in older adults with overweight/obesity and metabolic syndrome: a longitudinal evaluation in the PREDIMED-Plus cohort

• Published in: BMC Medicine 2023, Vol.21 (1)
• Main Authors: Shyam, Sangeetha, García-Gavilán, Jesús Francisco, Paz-Graniel, Indira, Gaforio, José J, Martínez-González, Miguel Ãngel, Corella, Dolores, Martínez, J. Alfredo, Alonso-Gómez, Ãngel M, Wärnberg, Julia, Vioque, Jesús, Romaguera, Dora, López-Miranda, José, Estruch, Ramon, Tinahones, Francisco J, Lapetra, José, Serra-Majem, J. Luís, Bueno-Cavanillas, Aurora, Tur, Josep A, Sánchez, Vicente Martín, Pintó, Xavier, Matía-Martín, Pilar, Vidal, Josep, Vázquez, Clotilde, Daimiel, Lidia, Ros, Emilio, Fernandez-Aranda, Fernando, Nishi, Stephanie K, Garcia-Regata, Oscar, Toledo, Estefania, Asensio, Eva M, Castaéer, Olga, Garcia-Rios, Antonio, Torres-Collado, Laura, Gómez-Gracia, Enrique, Zulet, M. Angeles, Ruiz, Nuria Goéi, Casas, Rosa, Cano-Ibáéez, Naomi, Tojal-Sierra, Lucas, Gómez-Perez, A. M, Sorlí, Jose V, Cinza-Sanjurjo, Sergio, Martín-Peláez, Sandra, Peéa-Orihuela, Patricia J, Oncina-Canovas, Alejandro, Perez-Araluce, Rafael, Zomeéo, María Dolores, Chaplin, Alice, Delgado-Rodríguez, Miguel, Babio, Nancy, Fitó, Montserrat, Salas-Salvadó, Jordi
• Format: Report
• Language: English
• Subjects: Body weight; Cardiovascular diseases; Coronaviruses
• ISSN: 1741-7015; 1741-7015
• DOI: 10.1186/s12916-023-03079-z

Cross-sectionally, older age and obesity are associated with increased coronavirus disease-2019 (COVID-19) risk. We assessed the longitudinal associations of baseline and changes in adiposity parameters with COVID-19 incidence in older adults at high cardiovascular risk. This analysis included 6874 men and women (aged 55-75 years) with overweight/obesity and metabolic syndrome in the PREDIMED-Plus lifestyle intervention trial for cardiovascular risk reduction. Body weight, body-mass-index (BMI), waist circumference, waist-to-height ratio (WHtR), and a body shape index (ABSI) were measured at baseline and annual follow-up visits. COVID-19 was ascertained by an independent Event Committee until 31 December 2021. Cox regression models were fitted to evaluate the risk of COVID-19 incidence based on baseline adiposity parameters measured 5-6 years before the pandemic and their changes at the visit prior to censoring. At the time of censoring, 653 incident COVID-19 cases occurred. Higher baseline body weight, BMI, waist circumference, and WHtR were associated with increased COVID-19 risk. During the follow-up, every unit increase in body weight (HR.sub.adj (95%CI): 1.01 (1.00, 1.03)) and BMI (HR.sub.adj: 1.04 (1.003, 1.08)) was associated with increased COVID-19 risk. In older adults with overweight/obesity, clinically significant weight loss may protect against COVID-19.