Obesity Strongly Predicts COVID-19-Related Major Clinical Adverse Events in Coptic Clergy

Michael Y Henein; Ibadete Bytyçi; Rachel Nicoll; Rafik Shenouda; Sherif Ayad; Federico Vancheri; Matteo Cameli

doi:10.3390/jcm10132752

Obesity Strongly Predicts COVID-19-Related Major Clinical Adverse Events in Coptic Clergy

J Clin Med. 2021 Jun 22;10(13):2752. doi: 10.3390/jcm10132752.

Authors

Michael Y Henein^{1

2

3}, Ibadete Bytyçi¹, Rachel Nicoll¹, Rafik Shenouda^{1

4}, Sherif Ayad⁵, Federico Vancheri⁶, Matteo Cameli⁷

Affiliations

¹ Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, Sweden.
² Molecular and Clinic Research Institute, St George University, London SW17 0QT, UK.
³ Institute of Fluid Dynamics, Brunel University, London UB8 3PH, UK.
⁴ International Cardiac Centre, Alexandria 21526, Egypt.
⁵ Department of Cardiology, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt.
⁶ Department of Internal Medicine, S. Elia Hospital, 93100 Caltanissetta, Italy.
⁷ Department of Medical Biotecnologies, Division of Cardiology, University of Siena, 53100 Siena, Italy.

Abstract

Background and aims: The Coptic clergy, due to their specific work involving interaction with many people, could be subjected to increased risk of infection from COVID-19. The aim of this study, a sub-study of the COVID-19-CVD international study of the impact of the pandemic on the cardiovascular system, was to assess the prevalence of COVID-19 among Coptic priests and to identify predictors of clinical adverse events.

Methods: Participants were geographically divided into three groups: Group-I: Europe and USA, Group II: Northern Egypt, and Group III: Southern Egypt. Participants' demographic indices, cardiovascular risk factors, possible source of infection, number of liturgies, infection management, and major adverse events (MAEs), comprising death, or mechanical ventilation, were assessed.

Results: Out of the 1570 clergy serving in 25 dioceses, 255 (16.2%) were infected. Their mean age was 49.5 ± 12 years and mean weekly number of liturgies was 3.44 ± 1.0. The overall prevalence rate was 16.2% and did not differ between Egypt as a whole and overseas (p = 0.23). Disease prevalence was higher in Northern Egypt clergy compared with Europe and USA combined (18.4% vs. 12.1%, p = 0.03) and tended to be higher than in Southern Egypt (18.4% vs. 13.6%, p = 0.09). Ten priests (3.92%) died of COVID-19-related complications, and 26 (10.2) suffered a MAE. The clergy from Southern Egypt were more obese, but the remaining risk factors were less prevalent compared with those in Europe and USA (p = 0.01). In multivariate analysis, obesity (OR = 4.180; 2.479 to 12.15; p = 0.01), age (OR = 1.055; 0.024 to 1.141; p = 0.02), and systemic hypertension (OR = 1.931; 1.169 to 2.004; p = 0.007) predicted MAEs. Obesity was the most powerful independent predictor of MAE in Southern Egypt and systemic hypertension in Northern Egypt (p < 0.05 for both).

Conclusion: Obesity is very prevalent among Coptic clergy and seems to be the most powerful independent predictor of major COVID-19-related adverse events. Coptic clergy should be encouraged to follow the WHO recommendations for cardiovascular disease and COVID-19 prevention.

Keywords: COVID-19; Coptic clergy; major adverse events; obesity; prevalence.