Abstract
Obesity is an emerging risk factor for coronavirus disease-2019 (COVID-19). Simple measures of physical fitness, such as self-reported walking pace, may also be important risk markers. This analysis includes 412,596 UK Biobank participants with linked COVID-19 data (median age at linkage = 68 years, obese = 24%, median number of comorbidities = 1). As of August 24th 2020, there were 1001 cases of severe (in-hospital) disease and 336 COVID-19 deaths. Compared to normal weight individuals, the adjusted odds ratio (OR) of severe COVID-19 in overweight and obese individuals was 1.26 (1.07, 1.48) and 1.49 (1.25, 1.79), respectively. For COVID-19 mortality, the ORs were 1.19 (0.88, 161) and 1.82 (1.33, 2.49), respectively. Compared to those with a brisk walking pace, the OR of severe COVID-19 for steady/average and slow walkers was 1.13 (0.98, 1.31) and 1.88 (1.53, 2.31), respectively. For COVID-19 mortality, the ORs were 1.44 (1.10, 1.90) and 1.83 (1.26, 2.65), respectively. Slow walkers had the highest risk regardless of obesity status. For example, compared to normal weight brisk walkers, the OR of severe disease and COVID-19 mortality in normal weight slow walkers was 2.42 (1.53, 3.84) and 3.75 (1.61, 8.70), respectively. Self-reported slow walkers appear to be a high-risk group for severe COVID-19 outcomes independent of obesity.
Highlights
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease-2019 (COVID-19), is devastating global economies and putting unprecedented strain on health care services and communities
2.58 (1.33, 5.02) whereas the odds in normal weight slow walkers was 3.75 (1.61, 8.70). Both obesity and self-reported walking pace are independently associated with the population level risk of severe COVID-19 and COVID-19 mortality in UK Biobank
Self-reported slow walkers had the highest risk regardless of their obesity status, with normal weight slow walkers having over twice the risk of severe disease and almost four times the risk of COVID-19 mortality compared to normal weight brisk walkers
Summary
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease-2019 (COVID-19), is devastating global economies and putting unprecedented strain on health care services and communities. Self-reported walking pace has been shown to be a stronger predictor of cardiovascular mortality than other measures of physical activity or function [9, 10], with self-reported slow walkers having a low life expectancy even in those with normal weight [8]. These findings suggest that self-reported walking pace acts as a simple easy to collect measure of overall physical health status. Well researched with cardiovascular and all-cause mortality outcomes, this hypothesis has not been established for infectious disease
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