CDC: More questionable advice - Printable Version

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CDC: More questionable advice - M T - 10-09-2020

The latest thing from the CDC is the claim that being overweight is a risk factor for poor outcome of COVID  ("Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19").  Totally weirdly, they do NOT note that being underweight is a risk factor for poor outcome.   My guess is they'll have to pull this shortly.

Two news reports associated the CDC position with this August meta-analysis.  If you go through it, the authors use "overweight/obese" throughout their verbiage, but when you look for data, here is the only thing on overweight (non-obese) mentioned:

Quote:A study used U.K. Biobank data (n = 285 817) to show that overweight increased the risk of COVID‐19 by 44.0% (relative risk [RR] = 1.44; 95% CI, 1.08–1.92; p = 0.0100) and individuals with obesity almost doubled the risk (RR = 1.97; 95% CI, 1.46–2.65; p < 0.0001), adjusted for age, sex, ethnicity and socio‐economic deprivation as measured by unemployment, assets and household density.32 The authors tested only a small portion of individuals (0.5%) for COVID‐19, a key limitation of this study. A better way to calculate OR for this study is to compare the odds between subjects who tested positive and those who tested negative. Our pooled data analysis showed that the odds of individuals with obesity being COVID‐19 positive were 46.0% (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001) higher than those of individuals who were not obese (Figure 3).

The reference [32] of that April study is
Ho FK, Celis‐Morales CA, Gray SR, et al. Modifiable and non‐modifiable risk factors for COVID‐19: results from UK Biobank. medRxiv. 2020: 2020.04.28.20083295.  Google Scholar
The title of Figure 3 is "Meta‐analysis of the association between individuals with obesity and the risk of testing positive for COVID‐19"

Dig down into that, and you'll find that the April study simply measured the number of reported cases of COVID versus the population.  (And, in my opinion, it had a fairly small number of COVID cases (340) - adjusting for population, that's about 3-weeks worth of SCC level of infection (at 107/day))  This is NOT a measure of a poor outcome of COVID, but simply the likelihood of getting the disease.  (The data of test results is NOT in the referenced April study.)  I don't see any of the August meta-analysis data regarding overweight but not obese individuals.

In any case, the April report at most measures the chance of getting COVID relative to body weight categories, not the risk of having a poor outcome.  The August paper did not include the April paper in the pooled data sets about the severity of COVID-19 (hospitalization, ICU admission, ventilation, death).

The August meta-analysis has neither a Results or Conclusion section. (The pre-article Summary does not mention "overweight".)  The first sentence in their Introduction claims "For persons with coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), there appears to be a strong relationship between being an individual with overweight or obesity and the risks of hospitalization and needing treatment in intensive care units (ICUs)."

In my opinion, the August meta-analysis does NOT have evidence for that claim regarding overweight individuals (I didn't look at their evidence related to obese individuals).  If the CDC relied on this meta-analysis, the meta-analysis provides no evidence for what the CDC is saying regarding overweight individuals.

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