COVID-19, body mass index and cholesterol: an ecological study using global data

Area of Science:

• Global Health
• Epidemiology
• Metabolic Health

Background:

• Coronavirus disease 2019 (COVID-19) presents a significant global threat to health, economy, and society.
• Factors such as Body Mass Index (BMI) have been implicated in COVID-19 outcomes.
• Understanding these associations is crucial for public health strategies.

Purpose of the Study:

• To investigate the correlation between national-level Body Mass Index (BMI) and cholesterol levels with the incidence and mortality of COVID-19.
• To assess the influence of these metabolic factors on COVID-19 outcomes across different countries.
• To identify specific populations where these risk factors may be more pronounced.

Main Methods:

• Ecological study design utilizing publicly available global data from WHO and NCD Risk Factor Collaboration.
• Analysis of age-standardized BMI and cholesterol levels against COVID-19 incidence and mortality ratios.
• Application of bivariate correlation, independent sample t-test, Mann-Whitney rank test, and multivariable linear regression.

Main Results:

• COVID-19 incidence and mortality were significantly higher in developed countries compared to developing countries.
• Correlations between BMI, cholesterol, and COVID-19 were stronger in countries with younger populations.
• BMI and cholesterol levels showed a positive correlation with both COVID-19 incidence (β=2396.81, β=30,932.80, p<0.01) and mortality (β=38.18, β=417.52, p<0.05) after adjusting for socioeconomic and demographic factors.

Conclusions:

• Aggregate national levels of BMI and cholesterol are significant risk factors for COVID-19 incidence and mortality.
• These metabolic factors represent critical risks for major COVID-19 outcomes, especially in developing countries with younger demographics.
• Monitoring and promoting healthier BMI and cholesterol levels are recommended to mitigate COVID-19 morbidity and mortality.