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Effects of obesity on COVID in the 2nd wave of the pandemic (including healthcare costs)

Status

Ongoing

Title

Effects of obesity on COVID in the 2nd wave of the pandemic (including healthcare costs)

What is the aim of the study and why is it important?

It is now established that infection with the coronavirus, called SARS-CoV-2, does not affect everyone equally, with some prone to get more severe illness, called COVID-19, than others. We have previously shown, using data from the first wave of the pandemic that being overweight is one of the factors that increases the risk of developing severe disease, defined as greater risk of hospitalisation, admission to ICU and death from COVID-19.

The COVID-19 pandemic has affected all aspects of society. Most countries have aimed to halt the spread of the virus by restricting social interactions, resulting in nationwide lockdowns, with significant decreases in nations’ economic productivity.
Although we have a clearer picture of individual characteristics that may increase susceptibility to severe COVID-19, the healthcare costs of treating patients who get COVID-19 have received less interest both from the research community and media outlets.
To deliver affordable and effective care systems during the current pandemic, and in the future, we need a comprehensive estimation of the costs of care.

The aim of this study is to work out the cost of treating the people hospitalised with COVID-19, and explore if there is an association between excess body weight and treatment costs for COVID-19.

Chief Investigator

Dr Nerys Astbury

Lead Applicant Organisation Name

Sponsor

Oxford

Location of research

University of Oxford

Date on which research approved

08-Feb-2022

Project reference ID

OX141

Generic ethics approval reference

18/EM/0400

Are all data accessed are in anonymised form?

Yes

Brief summary of the dataset to be released (including any sensitive data)

This is a prospective cohort study of patients registered in English general practices linked to data from Hospital Episode Statistics (HES).
People registered as patients and aged 18+ years on 1 January 2020 who were registered for the whole of 2019 and remained so until censoring at (Dates TBD); AND with a COVID-19 related admission to hospital.

What were the main findings?

Improved understanding of how body mass index (BMI) impacts a patient’s length of stay in hospital and likelihood of admission to intensive care can help the NHS ensure adequate resources are available to meet patient demand, according to a new study by researchers at Oxford Population Health’s Health Economics Research Centre. The study is published in The Lancet Diabetes & Endocrinology.

Excess weight is a known risk factor for severe disease after COVID-19 infection, but the effect of BMI on hospital resource use has not been fully quantified. This new study aimed to establish whether patients’ BMI influenced their length of stay in hospital, their likelihood of admission to intensive care, and the total cost of their hospital care.

Whilst people living with obesity* make up approximately 26% of the UK population, the researchers found that people with obesity accounted for 44% of hospital admissions for COVID-19 in the UK between 1 April 2020 and 31 December 2021. Patients with obesity were significantly more likely to be admitted to intensive care, and the costs of their hospitalisations were significantly higher.

The researchers analysed data from 57,415 adult patients in England who were admitted to hospital with COVID-19 between 1 April 2020 and 31 December 2021. They looked at how long the patients stayed in hospital, whether they needed to be transferred to an intensive care unit, and how long those patients stayed in intensive care. The costs of hospitalisation were estimated based on these factors. The researchers compared the resource use of patients living with obesity with a reference group who had a BMI of between 18.5 and 25kg/m2, defined by the NHS as the ‘healthy range’. The key findings were:

Patients with obesity typically had longer length of stays in hospital than the reference group, at an average of 9.22 days, compared with 8.82 days for the reference group;
Whilst accounting for differences in patients’ comorbidities, patients living with obesity were twice as likely to be admitted to intensive care when compared with the reference group;
The average of cost of being hospitalised with COVID-19 for patients with a BMI of 18.5-25kg/m2 was £19,877. Accounting for differences in patients’ comorbidities, on average patients with overweight but not obesity had £794 higher costs for each admission than patients at a healthy weight. Patients with obesity had on average £2,736 higher costs for each hospital stay;
COVID-19 hospitalisations were estimated to cost the NHS £13.7billion during the study period, with treatment of patients with overweight or obesity estimated to account for 78% (£10.7billion) of total hospital expenditure for COVID-19.
James Altunkaya, lead author and DPhil candidate at Oxford Population Health, said ‘Excess weight and its related conditions are a major driver of ill-health, and these conditions are having an increasing impact on many more individuals than ever before.

Delivering appropriate healthcare resources to areas with higher proportions of people living with obesity is an important component of addressing persistent health inequities seen in the UK.

Our findings support the case for further investment in prevention efforts to reduce the impact of obesity and its associated conditions on individuals, and on the healthcare system at large.’

*defined as having a BMI of more than 30kg/m2

Public Benefit Statement

Research Team

Dr Nerys Astbury, University of Oxford 

Dr Carmen Piernas-Sanchez, University of Oxford

Professor Susan Jebb, University of Oxford 

Professor Paul Aveyard, University of Oxford 

Dr Jose Leal, University of Oxford 

Professor Phillip Clarke, University of Oxford 

Publications

Press Releases

Access Type

Trusted Research Environment (TRE)

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