A patient with overweight or obesity: lessons from COVID-19 pandemic (EVA observational study data)

Aim . To evaluate the health status and outcomes of patients with overweight (pre-obesity) or obesity during long-term follow-up as part of the EVA observational program. Material and methods . The EVA study included patients with over­weight and obesity (body mass index (BMI) >25 kg/m 2 ) from the out­patient registry of patients with cardiovascular diseases or their risk fac­tors from April 8, 2019 to March 24, 2020. One and three years after the enrollment visit (coinciding with the COVID-19 pandemic), we con­tacted patients by telephone to collect information on body weight at the survey date, medication adherence, and subjective assessment of pre-obesity/obesity. At the three-year follow-up, data were collected on COVID-19 history and the changes of comorbid conditions during the COVID-19 pandemic. Results . The study included 295 patients. The mean follow-up period was 3,6±0,5 years. The second telephone contact yielded following information on 261 (88,5%) patients: 18 — died, 243 — alive. In ad­dition, 129 (43,7%) patients had COVID-19. Adherent patients and older people were less susceptible to the risk of COVID-19 infection compared to non-adherent and younger patients (p=0,016 and p=0,043, respectively). Every third (32,3%) patient who had COVID-19 experienced worsening of noncommunicable diseases (NCDs), and almost every fourth (23,4%) patient developed new-onset NCDs. A decrease in weight self-assessment criticality was found, especially in patients with pre-obesity, 40% of whom considered their body weight to be normal. Predictors of adverse outcomes were prior myocardial infarction (hazard ratio (HR)=6,10; 95% confidence interval (CI): 1,18-31,46 (p=0,031)), type 2 diabetes (HR=2,78; 95% CI: 1,03-7,51, p=0,043) and BMI (HR=1,12; 95% CI: 1,01-1,24 (p=0,035)). Conclusion . Significant predictors of an unfavorable prognosis in patients over a 3-year follow-up period were elevated BMI, prior myocardial infarction, and diabetes. After COVID-19, one-third of pa­tients experienced progression of existing noncommunicable diseases, and one in four patients developed a new-onset NCDs. Non-adherence was one of two factors associated with COVID-19 in­fec­tion. During the COVID-19 pandemic, a slight decrease in weight self-as­sessment criticality was noted in patients with pre-obesity or obesity.