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Eur J Med Res . Obesity is associated with increased severity of disease in COVID-19 pneumonia: a systematic review and meta-analysis

tetano

Editor, Senior Moderator
Eur J Med Res


. 2020 Dec 2;25(1):64.
doi: 10.1186/s40001-020-00464-9.
Obesity is associated with increased severity of disease in COVID-19 pneumonia: a systematic review and meta-analysis


Yanan Chu[SUP] 1 [/SUP], Jinxiu Yang[SUP] 1 [/SUP], Jiaran Shi[SUP] 1 [/SUP], Pingping Zhang[SUP] 1 2 [/SUP], Xingxiang Wang[SUP] 3 [/SUP]



Affiliations

Abstract

Background: Obesity has been widely reported to be associated with the disease progression of coronavirus disease 2019 (COVID-19); however, some studies have reported different findings. We conducted a systematic review and meta-analysis to investigate the association between obesity and poor outcomes in patients with COVID-19 pneumonia.
Methods: A systematic review and meta-analysis of studies from the PubMed, Embase, and Web of Science databases from 1 November 2019 to 24 May 2020 was performed. Study quality was assessed, and data extraction was conducted. The meta-analysis was carried out using fixed-effects and random-effects models to calculate odds ratios (ORs) of several poor outcomes in obese and non-obese COVID-19 patients.
Results: Twenty-two studies (n = 12,591 patients) were included. Pooled analysis demonstrated that body mass index (BMI) was higher in severe/critical COVID-19 patients than in mild COVID-19 patients (MD 2.48 kg/m[SUP]2[/SUP], 95% CI [2.00 to 2.96 kg/m[SUP]2[/SUP]]). Additionally, obesity in COVID-19 patients was associated with poor outcomes (OR = 1.683, 95% CI [1.408-2.011]), which comprised severe COVID-19, ICU care, invasive mechanical ventilation use, and disease progression (OR = 4.17, 95% CI [2.32-7.48]; OR = 1.57, 95% CI [1.18-2.09]; OR = 2.13, 95% CI [1.10-4.14]; OR = 1.41, 95% CI [1.26-1.58], respectively). Obesity as a risk factor was greater in younger patients (OR 3.30 vs. 1.72). However, obesity did not increase the risk of hospital mortality (OR = 0.89, 95% CI [0.32-2.51]).
Conclusions: As a result of a potentially critical role of obesity in determining the severity of COVID-19, it is important to collect anthropometric information for COVID-19 patients, especially the younger group. However, obesity may not be associated with hospital mortality, and efforts to understand the impact of obesity on the mortality of COVID-19 patients should be a research priority in the future.

Keywords: COVID-19; Meta-analysis; Obesity; Poor outcomes.
 
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