Background: Obesity and T2D are risk factors for SARS-CoV-2 outcomes, but less is known about non-hospitalized cases. We hypothesized that those with obesity or T2D are more likely to have a positive Covid test, and among those with a positive test, to have symptoms.

Methods: Among 31,117 North Carolina Covid Community Research Partnership participants with EHR data, we evaluated the association of self-reported and EHR obesity and T2D with a self-reported positive Covid test at any time. Among 2,418 participants with a positive test during the study, we evaluated the association of obesity and T2D with self-report of symptoms. Logistic regression models were adjusted for age, sex, race/ethnicity, socioeconomic status, and healthcare worker status.

Results: We found a positive graded association between BMI category and positive Covid test, and a similar but weaker association with Covid symptoms among those with a positive test (Table) . T2D was associated with Covid infection but not symptoms.

Conclusions: While the limitations of this health system convenience sample include generalizability and test seeking selection bias, the strong graded association of BMI and T2D with self-reported Covid infection suggests that obesity and T2D may play a role in risk for symptomatic SARS-CoV-2 beyond co-occurrence with socioeconomic risk factors.


M.Mongraw-chaffin: None. S.Edelstein: None. A.H.Tjaden: None. A.Seals: None. K.Miller: None. N.Ahmed: None. M.Espeland: None. M.A.Gibbs: None. D.Uschner: None. W.S.Weintraub: None.


The CARES Act of the U.S. Department of Health and Human Services (HHS) [Contract # NC DHHS GTS #49927].

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