Delayed SARS-CoV-2 Clearance in Patients with Obesity

Xiujun Zhang,1,2 Bin Lin,3 Gang Yang,4 Longgen Liu,1,2 Jianchun Lu,1,2 Zhaohui Lu,4 Yuan Xue1,2 1Institute of Hepatology, The Third People’s Hospital of Changzhou, Changzhou, People’s Republic of China; 2Department of Liver Diseases, The Third People’s Hospital of Changzhou, Changzhou, People’s Republic of China; 3Department of Infectious Diseases, The First People’s Hospital of Jintan, Changzhou, People’s Republic of China; 4Department of Respiratory Diseases, The Second People’s Hospital of Wuhu, Wuhu, People’s Republic of ChinaCorrespondence: Zhaohui Lu; Yuan Xue Email lzh1980222@163.com; xueyuan80908@163.comObjective: The present study aimed to investigate the correlation between obesity and virus persistence in patients with COVID-19.Design and Methods: A total of 57 patients with laboratory-confirmed COVID-19 were admitted to two clinical centers, and data were analyzed retrospectively. Among them, 18 patients with body mass index (BMI) ≥ 25 kg/m2 were diagnosed with obesity, and dynamics of viral replication were compared.Results: Eighteen patients were diagnosed with obesity. The correlations between BMI and white blood cell, C-reactive protein, and cycle threshold (Ct) values of ORF1ab were not significant (all P > 0.05). On day 7 after admission, virus clearance was achieved in 13 (33.3%) patients with BMI < 25 kg/m2 and 5 (27.8%) patients with BMI ≥ 25 kg/m2 (χ2 = 0.176, P =0.68). On day 14, the RNA tests were negative in 37 (94.9%) patients with BMI < 25 kg/m2 and 13 (72.2%) patients with BMI ≥ 25 kg/m2 (χ2 = 5.865, P = 0.03). Multivariable analysis showed that only BMI ≥ 25 kg/m2 (P = 0.02) was the independent risk factor for virus clearance on day 14.Conclusion: Obesity may affect the clearance of SARS-CoV-2, and BMI should be assessed in patients with COVID-19, although they are not seriously ill.Keywords: SARS-CoV2, COVID-19, body mass index, obesity, virus clearance