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We aimed to estimate the total secondary care costs by body mass index (BMI, kg\/m<jats:sup>2<\/jats:sup>) category when hospitalized due to COVID\u201019 in Europe during the first wave of the pandemic from January to June 2020. Building a health\u2010care cost model, this study aimed to estimate the total costs of COVID\u201019. Information on risk of hospitalization, admission to intensive care unit (ICU) and risk of ventilation were based on published data. Average cost per patient and in total were calculated based on risks of admission to ICU, risk of invasive mechanical ventilation and length of hospital stay when hospitalized and published costs associated with hospitalization. The total direct costs of secondary care during the first wave of COVID\u201019 in Europe were estimated at EUR 13.9 billon, whereof 76% accounted for treating people with overweight and obesity. The average cost per hospital admission increased with BMI, from EUR 15831 for BMI &lt;25\u2009kg\/m<jats:sup>2<\/jats:sup> to EUR 30982 for BMI \u226540\u2009kg\/m<jats:sup>2<\/jats:sup>. This study reveals that excess weight contributes disproportionally to the costs of COVID\u201019. This might reflect that overweight and obesity caused the COVID\u201019 pandemic to result in more severe outcomes for citizens and higher secondary care costs throughout Europe.<\/jats:p>","DOI":"10.1111\/cob.12442","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T22:08:16Z","timestamp":1612822096000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Costs of the <scp>COVID<\/scp>\u201019 pandemic associated with obesity in Europe: A health\u2010care cost model"],"prefix":"10.1111","volume":"11","author":[{"given":"Sebastien","family":"Czernichow","sequence":"first","affiliation":[{"name":"Service de Nutrition Universit\u00e9 de Paris  Paris France"},{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris (AP\u2010HP) Service de Nutrition, Centre Sp\u00e9cialis\u00e9 Ob\u00e9sit\u00e9, H\u00f4pital Europ\u00e9en Georges Pompidou  Paris France"},{"name":"METHODS Team INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cit\u00e9 Centre (CRESS)  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen C.","family":"Bain","sequence":"additional","affiliation":[{"name":"Diabetes Research Unit Swansea University Medical School and Swansea Bay University Health Board  Swansea Wales UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Capehorn","sequence":"additional","affiliation":[{"name":"Rotherham Institute for Obesity (RIO) Clifton Medical Centre  Rotherham South Yorkshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0866-9414","authenticated-orcid":false,"given":"Mette","family":"B\u00f8gelund","sequence":"additional","affiliation":[{"name":"Incentive Denmark  Holte Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elmegaard","family":"Madsen","sequence":"additional","affiliation":[{"name":"Incentive Denmark  Holte Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilie","family":"Yssing","sequence":"additional","affiliation":[{"name":"Incentive Denmark  Holte Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabell Cajus","family":"McMillan","sequence":"additional","affiliation":[{"name":"Incentive Denmark  Holte Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana\u2010Paula","family":"Cancino","sequence":"additional","affiliation":[{"name":"Novo Nordisk North West Europe Pharmaceuticals A\/S  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik Haagen","family":"Panton","sequence":"additional","affiliation":[{"name":"Novo Nordisk North West Europe Pharmaceuticals A\/S  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,7]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Johns Hopkins University.COVID\u201019 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). 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