Weight trajectories and abdominal adiposity in COVID-19 survivors with overweight/obesity

Background COVID-19 is associated with unintentional weight loss. Little is known on whether and how patients regain the lost weight. We assessed changes in weight and abdominal adiposity over a three-month follow-up after discharge in COVID-19 survivors. Methods In this sub-study of a large prospective observational investigation, we collected data from individuals who had been hospitalized for COVID-19 and re-evaluated at one (V1) and three (V2) months after discharge. Patient characteristics upon admission and anthropometrics, waist circumference and hunger levels assessed during follow-up were analyzed across BMI categories. Results One-hundred-eighty-five COVID-19 survivors (71% male, median age 62.1 [54.3; 72.1] years, 80% with overweight/obesity) were included. Median BMI did not change from admission to V1 in normal weight subjects (−0.5 [−1.2; 0.6] kg/m 2 , p = 0.08), but significantly decreased in subjects with overweight (−0.8 [−1.8; 0.3] kg/m 2 , p < 0.001) or obesity (−1.38 [−3.4; −0.3] kg/m 2 , p < 0.001; p < 0.05 vs . normal weight or obesity). Median BMI did not change from V1 to V2 in normal weight individuals (+0.26 [−0.34; 1.15] kg/m 2 , p = 0.12), but significantly increased in subjects with overweight (+0.4 [0.0; 1.0] kg/m 2 , p < 0.001) or obesity (+0.89 [0.0; 1.6] kg/m 2 , p < 0.001; p = 0.01 vs . normal weight). Waist circumference significantly increased from V1 to V2 in the whole group ( p < 0.001), driven by the groups with overweight or obesity. At multivariable regression analyses, male sex, hunger at V1 and initial weight loss predicted weight gain at V2. Conclusions Patients with overweight or obesity hospitalized for COVID-19 exhibit rapid, wide weight fluctuations that may worsen body composition (abdominal adiposity). ClinicalTrials.gov registration NCT04318366.