“COVID-19 outcome disparities are rapidly becoming apparent for people with obesity and multiple black, Asian, and minority ethnic (BAME) groups. Researchers have reported differences in COVID-19 hospitalization and mortality rates by race/ethnicity in the United Kingdom (UK) [1, 2] and United States (US) [3, 4]. Numerous minority ethnic groups in these countries live with a greater burden of obesity and other chronic diseases. This is particularly significant as obesity has emerged as a risk factor for severe COVID-19, the disease caused by novel coronavirus SARS-CoV-2 [3, 5]. We synthesize a range of potential biological, socioeconomic, behavioral, and sociological contributors to the disparate outcomes for people with obesity and minority ethnic groups in COVID-19.
Initial retrospective cohort analyses have demonstrated higher rates of hospitalization and intensive care, including invasive mechanical ventilation, for patients with obesity [5, 6]. Though these observational results do not assess mortality outcomes and adjust for few comorbidities, they signal potential biologic vulnerability for a large proportion of people worldwide living with obesity. Obesity rates are significantly higher among Hispanic and African Americans, as well as black, Bangladeshi, and Pakistani groups in the UK, than their white counterparts [1, 7]. The overlap of COVID-19 risk signals between obesity and ethnicity therefore is of consequence.”