Extreme Obesity Linked to H1N1 Mortality

Extremely obese individuals may need priority vaccination and faster treatment for pandemic flu.

Extremely obese patients presenting with flu-like symptoms should raise red flags for pharmacists and other health care professionals, a new study suggests. According to research published in the February issue of Clinical Infectious Diseases, patients with a body mass index (BMI) of 40 or higher are almost 3 times as likely to die from H1N1 as those with a normal BMI.

Janice Loui, MD, of the California Department of Health in Richmond, California, and colleagues looked at medical records of 534 patients who were hospitalized for 2009 H1N1 infection. Among the 92 patients who died, 61% had a BMI of 30 or higher, and 30% had a BMI of 40 or higher. Patients with a BMI of 45 or higher were the most likely to die from H1N1.

The study is the first of its kind to identify obesity—rather than its comorbidities—as an independent risk factor for H1N1 mortality. The trial results also showed that obese patients were more likely to be treated later than nonobese patients. Among those studied, approximately two thirds of obese patients received treatment more than 48 hours after symptom onset.

The researchers suggest extremely obese patients be given priority vaccination status similar to that which is granted to seniors. “BMI categories could be added to current high risk groups for prioritization of antiviral use and influenza vaccine immunization in times of supply shortages,” they concluded.

For other articles in this issue, see:

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