Evidence map›Paper›PMID 30515985›Full record

Observational studyInfluenza and other respiratory viruses2019

Underweight, overweight, and obesity as independent risk factors for hospitalization in adults and children from influenza and other respiratory viruses.

Joe-Ann S Moser, Arturo Galindo-Fraga, Ana A Ortiz-Hernández, Wenjuan Gu, Sally Hunsberger, Juan-Francisco Galán-Herrera, María Lourdes Guerrero, Guillermo M Ruiz-Palacios, John H Beigel, La Red ILI 002 Study Group

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Influenza and other respiratory viruses, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
100citing papers in PubMed, 8 pooled it
17.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

100 citing papers in PubMed, 8 syntheses or guidelines pooled it, 170 citations in OpenAlex.

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  12. Body Size and Risk of Death During the 1918 Influenza Pandemic in Alaska.American journal of human biology : the official journal of the Human Biology Council · 2025
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40 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

Joe-Ann S MoserNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
Arturo Galindo-FragaInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Ana A Ortiz-HernándezInstituto Nacional de Pediatría, Mexico City, Mexico.ORCID 0000-0001-6505-0066
Wenjuan GuLeidos Biomedical Research Inc. in support of National Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
Sally HunsbergerNational Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
Juan-Francisco Galán-HerreraMexico Emerging Infectious Disease Clinical Research Network Coordinating Center, Mexico City, Mexico.
María Lourdes GuerreroInstituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.ORCID 0000-0002-4039-0782
Guillermo M Ruiz-PalaciosComisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Mexico City, Mexico.
John H BeigelLeidos Biomedical Research Inc. in support of National Institute of Allergy and Infectious Diseases, Bethesda, Maryland.ORCID 0000-0002-4879-4941
La Red ILI 002 Study Group
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán · MXLeidos (United States) · USNational Institute of Allergy and Infectious Diseases · USHospitales Regionales de Alta Especialidad · MXInstituto Nacional de Pediatria · MXMSD (Mexico) · MX

Funding

CCR NIH HHS HHSN261200800001CNCI NIH HHS HHSN261200800001ENCI NIH HHS HHSN261201500003CNCI NIH HHS HHSN261201500003INIAID NIH HHS HHSN272200900001CNIAID NIH HHS HHSN272200900031C
6 · The paper itself

Abstract

backgroundThe relationship between obesity and risk of complications described during the 2009 influenza pandemic is poorly defined for seasonal influenza and other viral causes of influenza-like illness (ILI).

methodsAn observational cohort of hospitalized and outpatient participants with ILI was conducted in six hospitals in Mexico. Nasopharyngeal swabs were tested for influenza and other common respiratory pathogens.

resultsA total of 4778 participants were enrolled in this study and had complete data. A total of 2053 (43.0%) had severe ILI. Seven hundred and seventy-eight (16.3%) were positive for influenza, 2636 (55.2%) were positive for other viral respiratory pathogens, and 1364 (28.5%) had no respiratory virus isolated. Adults with influenza were more likely to be hospitalized if they were underweight (OR: 5.20), obese (OR: 3.18), or morbidly obese (OR: 18.40) compared to normal-weight adults. Obese adults with H1N1 had a sixfold increase in odds of hospitalization over H3N2 and B (obese OR: 8.96 vs 1.35, morbidly obese OR: 35.13 vs 5.58, respectively) compared to normal-weight adults. In adults with coronavirus, metapneumovirus, parainfluenza, and rhinovirus, participants that were underweight (OR: 4.07) and morbidly obese (OR: 2.78) were more likely to be hospitalized as compared to normal-weight adults. All-cause influenza-like illness had a similar but less pronounced association between underweight or morbidly obesity and hospitalization.

conclusionsThere is an increased risk of being hospitalized in adult participants that are underweight or morbidly obese, regardless of their viral pathogen status. Having influenza, however, significantly increases the odds of hospitalization in those who are underweight or morbidly obese.

Indexed as

AdultAgedBody Mass IndexChildChild, PreschoolCohort StudiesFemaleHospitalizationHumansInfantInfluenza, HumanMaleMiddle AgedNasopharynxObesityObesity, Morbidbody mass indexhospital burden of diseaseinfluenzaobesityrespiratory viral pathogens

Identifiers

PMID30515985
PMCPMC6304312
OpenAlexW2903256957

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.