Abstract

SummaryThe disease course of COVID‐19 varies from asymptomatic infection to critical condition leading to mortality. Identification of prognostic factors is important for prevention and early treatment. We aimed to examine whether obesity is a risk factor for the critical condition in COVID‐19 patients by performing a meta‐analysis. The review protocol was registered onto PROSPERO (CRD42020185980). A systematic search was performed in five scientific databases between 1 January and 11 May 2020. After selection, 24 retrospective cohort studies were included in the qualitative and quantitative analyses. We calculated pooled odds ratios (OR) with 95% confidence intervals (CIs) in meta‐analysis. Obesity was a significant risk factor for intensive care unit (ICU) admission in a homogenous dataset (OR = 1.21, CI: 1.002‐1.46; I2 = 0.0%) as well as for invasive mechanical ventilation (IMV) (OR = 2.05, CI: 1.16‐3.64; I2 = 34.86%) in COVID‐19. Comparing body mass index (BMI) classes with each other, we found that a higher BMI always carries a higher risk. Obesity may serve as a clinical predictor for adverse outcomes; therefore, the inclusion of BMI in prognostic scores and improvement of guidelines for the intensive care of patients with elevated BMI are highly recommended.

Highlights

  • Six studies with 2,770 patients reported on intensive care unit (ICU) admission, the proportion of which ranged from 9% to 43%

  • We could not perform a conclusive metaregression to assess the correlation between body mass index (BMI) and ICU admission, it is well known that obesity carries enhanced risk of chronic diseases that could contribute to the increased need for ICU admission and unfavourable outcomes in COVID-19 patients

  • Our meta-analysis and systematic review revealed that obesity is a significant risk factor for ICU admission and for invasive mechanical ventilation (IMV) requirement in COVID-19

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Summary

Objectives

We aimed to examine whether obesity is a risk factor for the critical condition in COVID-19 patients by performing a meta-analysis. We aimed to clarify the association between the patients' BMI and ICU admission and IMV requirement

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