Introduction
Overweight and obesity may affect an individual’s immune response and their risk of infections, such as a SARS-CoV-2 infection. Long-term exposure to being overweight as well as body fat distribution could also be relevant for this risk. However, knowledge is limited. Therefore, the aim of this study was to investigate the association between the degree and duration of (abdominal) overweight and SARS-CoV-2 infection among adults from nine Dutch population-based prospective cohorts.
Methods
Nine prospective cohorts of the Netherlands Cohort Consortium, with a total of 99,570 participants, analyzed their data according to a standardized protocol. Body mass index (BMI) and waist circumference (WC) were assessed two times before the COVID-19 pandemic, with a period of about 5 years between both measurements. SARS-CoV-2 infection was defined by self-report as a positive PCR or rapid-antigen test or as COVID-19 ascertained by a physician between March 2020 and January 2023. For three cohorts, information on SARS-CoV-2 infection by serology was also available. Results were pooled using random-effects meta-analyses.
Results
Individuals with moderate overweight had a 1.08 times higher odds of a self-reported SARS-CoV-2 infection than individuals with a normal body weight (odds ratio (OR)=1.08, 95% confidence interval (CI) 1.04-1.13, I2=0%). Among individuals with obesity, this OR was 1.43 (95% CI, 1.18–1.75, I2=56%). These results were comparable to the ORs for abdominal overweight (OR=1.09, 95% CI 1.04–1.14, I2=0%) and abdominal obesity (OR=1.24, 95% CI 0.999–1.55, I2=57%). The results according to the duration of obesity show that the higher odds of a SARS-CoV-2 infection (either self-reported or based on serology) was not observed among individuals who shift from (abdominal) obesity at the least recent measurement to overweight or a normal weight at the most recent measurement.
Conclusion
This study pooling data from nine Dutch population-based prospective cohorts shows that besides obesity, (abdominal) overweight increases the risk of a SARS-CoV-2 infections. Individuals with obesity long before the pandemic, but a healthier body weight just before the pandemic were not at increased risk. These results underline once more the importance of overweight prevention for public health.