Abstract
The coronavirus disease 2019 (COVID-19) epidemic is spreading globally. Studies revealed that obesity may affect the progression and prognosis of COVID-19 patients. The aim of the meta-analysis is to identify the prevalence and impact of obesity on COVID-19. Studies on obese COVID-19 patients were obtained by searching PubMed, Cochrane Library databases and Web of Science databases, up to date to 5 June 2020. And the prevalence rate and the odds ratio (OR) of obesity with 95% confidence interval (CI) were used as comprehensive indicators for analysis using a random-effects model. A total of 6081 patients in 11 studies were included. The prevalence of obesity in patients with COVID-19 was 30% (95% CI 21-39%). Obese patients were 1.79 times more likely to develop severe COVID-19 than non-obese patients (OR 1.79, 95% CI 1.52-2.11, P < 0.0001, I2 = 0%). However obesity was not associated with death in COVID-19 patients (OR 1.05, 95% CI 0.65-1.71, P = 0.84, I2 = 66.6%). In dose-response analysis, it was estimated that COVID-19 patients had a 16% increased risk of invasive mechanical ventilation (OR 1.16, 95% CI 1.10-1.23, P < 0.0001) and a 20% increased risk of admission to ICU (OR 1.20, 95% CI 1.11-1.30, P < 0.0001) per 5 kg/m2 increase in BMI. In conclusion, obesity in COVID-19 patients is associated with severity, but not mortality.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and poses a serious threat to world public health security [1,2,3]
Inclusion criteria: (1) Participants: patients diagnosed with SARS-CoV-2 infection; (2) Intervention: COVID-19 patients with obesity included body mass index (BMI) data; (3) Outcome: the prevalence and the odds ratio (OR) of obesity with 95% confidence interval (CI); (4) Study: Observational studies such as cohort studies on COVID-19 and obesity, which were written in English language
The results showed that the OR of death in COVID-19 patients per 5 kg/m2 increase in body mass index was 0.96
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and poses a serious threat to world public health security [1,2,3]. Obesity is associated with an increased risk of cardiovascular disease and diabetes [6, 7]. Recent investigations have reported that obesity might increase the risk of SARS-CoV-2 infection and affect the prognosis of patients with COVID-19 [12, 13]. Whereas some cohort studies with COVID-19 disease found obesity rates were generally reported as no higher than population-based estimates [14, 15]. Emerging data support a survival benefit of obesity in critical illness, and the phenomenon has been coined ‘the obesity survival paradox’ [18, 19] It remains controversial whether obesity is related to increased susceptibility and adverse outcomes among patients with COVID-19 owing to the heterogeneous source of the existing cohort data
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