Matamalas Joan T, Chelvanambi Sarvesh, Decano Julius L, França Raony F, Halu Arda, Santinelli-Pestana Diego V, Aikawa Elena, Malhotra Rajeev, Aikawa Masanori
Department of Medicine, Cardiovascular Division, Center for Interdisciplinary Cardiovascular Sciences, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP 01246-903, Brazil.
PNAS Nexus. 2024 Aug 27;3(8):pgae294. doi: 10.1093/pnasnexus/pgae294. eCollection 2024 Aug.
The coronavirus disease (COVID-19) pandemic has occurred in Massachusetts in multiple waves led by a series of emerging variants. While the evidence has linked obesity with severe symptoms of COVID-19, the effect of obesity on susceptibility to SARS-CoV-2 infection remains unclear. Identification of intrinsic factors, which increase the likelihood of exposed individuals succumbing to productive SARS-CoV-2 infection could help plan mitigation efforts to curb the illness. We aim to investigate whether obese individuals have a higher susceptibility to developing productive SARS-CoV-2 infection given comparable exposure to nonobese individuals. This case-control study leveraged data from the Mass General Brigham's (MGB) electronic medical records (EMR), containing 687,813 patients, to determine whether obesity at any age increases the proportion of infections. We used PCR results of 72,613 subjects who tested positive to SARS-CoV-2 or declared exposure to the virus independently of the result of the test. For this study, we defined susceptibility as the likelihood of testing positive upon suspected exposure. We demonstrate evidence that SARS-CoV-2 exposed obese individuals were more prone to become COVID positive than nonobese individuals [adjusted odds ratio = 1.34 (95% CI: 1.29-1.39)]. Temporal analysis showed significantly increased susceptibility in obese individuals across the duration of the pandemic in Massachusetts. Obese exposed individuals are at a higher risk of getting infected with SARS-CoV-2. This indicates that obesity is not only a risk factor for worsened outcomes but also increases the risk for infection upon exposure. Identifying such populations early will be crucial for curbing the spread of this infectious disease.
冠状病毒病（COVID-19）大流行在马萨诸塞州以一系列新出现的变异毒株为先导呈现多波疫情。虽然有证据表明肥胖与COVID-19的严重症状有关，但肥胖对感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）易感性的影响仍不清楚。确定增加接触者感染SARS-CoV-2并发病可能性的内在因素有助于制定缓解措施以控制疫情。我们旨在研究在接触情况相当的条件下，肥胖个体感染SARS-CoV-2并发病的易感性是否高于非肥胖个体。这项病例对照研究利用了麻省总医院布莱根分院（MGB）电子病历（EMR）中的数据，该病历包含687,813名患者，以确定任何年龄段的肥胖是否会增加感染比例。我们使用了72,613名SARS-CoV-2检测呈阳性或自述接触过该病毒（与检测结果无关）的受试者的PCR结果。在本研究中，我们将易感性定义为疑似接触后检测呈阳性的可能性。我们证明，与非肥胖个体相比，接触SARS-CoV-2的肥胖个体更易感染COVID-19呈阳性[调整后的优势比=1.34（95%置信区间：1.29-1.39）]。时间分析表明，在马萨诸塞州大流行期间，肥胖个体的易感性显著增加。接触过病毒的肥胖个体感染SARS-CoV-2的风险更高。这表明肥胖不仅是病情恶化的危险因素，而且还会增加接触后感染的风险。尽早识别这类人群对于遏制这种传染病的传播至关重要。
