Determinants of Covid-19 Severity Among Adult Overweight/obese Patients Admitted at Addiss Abeba Covid Centers, Ethiopia: An Unmatched Case-control Study
Authors: tadesse Afomia , Bonsa Shimels , Woredebrhan Gelila , Alemu Wagaye , Andargie Melkam , Sime Yohanes , Birhane Mahlet , Melese Medhanit , Hussen Robel 
Published: July 2023

Abstract
Background: Coronaviruses are infectious agents belonging to the Coronaviridae family that infect both animal and human. The virus is mainly transmitted from person to person mainly by air droplets during sneezing, coughing, speaking or even breathing. COVID-19 has sign and symptom of extreme fatigue, lethargy, or malaise, muscle aches or joint pain, nausea, vomiting and/or diarrhoea, sore throat, rhinorrhoea or nasal congestion, headache and decreased or lack of appetite with respiratory symptoms such as fever, cough, and shortness of breath and loss of smell or taste. It causes mild to moderate respiratory difficulties in the majority of people. Others, especially those with concomitant conditions like obesity may require prompt medical attention. However, little is known about what causes severity among overweight/obese patients admitted to hospital.
Objectives: To identify determinants of COVID-19 severity among adult overweight/obese patients admitted at Addis Ababa COVID-19 treatment centers, Addis Ababa, Ethiopia 2022.
Methods: Facility-based unmatched case control study was conducted among 252(148 controls and 82 cases). Cases were overweight/obese COVID-19 patients with severity symptom while controls were overweight/obese COVID-19 patients without severity. All overweight/obese COVID-19 patients were included sequentially in the study. Data was collected using medical records and an interviewer administered questionnaire. Data was analyzed by SPSS version 25. Bivariable and multivariable logistic regression analysis was done to identify determinants of COVI19 severity, AOR with 95% of CI with p value ≤ 0.5 was used to declare statistical significance.
Results: From 252 samples 248 participants participated with a 98.4% of response rate. Majority 50 (61%) of the cases and 66 (39.8%) of the total controls were male. More than one third 32 (39%) of the cases and 100 (60.2%) of the controls were female. The mean age of the cases was 51.09 (SD=±11.18) and 43.25 (SD=±12.80) for the controls. In the multivariable analysis, taking COVID-19 vaccine was associated with lower risk [(AOR=0.2, 95%CI=0.11-0.50)] of covid-19 disease severity among overweight/obese patients. Conversely, raised BP during infection], age above 59 years, being in age category of 40-59, being a current smoker, ever smoker [(AOR=5.2, 95%CI=1.37-7.71)] and presence of known comorbidities [(AOR=3.9, 95%CI=1.89-6.32)] were associated with higher risks of covid-19 severity among overweight/obese patients.
Conclusion: COVID-19 severity among overweight/obese patients in Addis Ababa was associated with the patients’ blood pressure status, COVID-19 vaccine, smoking and comorbidity as well as older age. Therefore, clinicians, patient caregivers and programmers should give special attention to overweight/obese patients admitted to treatment centres with the above risk factors to save their lives, while advocating for COVID-19 vaccination.
Reference number:- duirb/059/22-03
Date 22/3/2022