The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and meta-analysis.

Tahereh Raeisi,Nazaninzahra Sepehri,Shahab Alizadeh,Mina Darand,Bahman Razi,Hadis Mozaffari,Mohammad Alizadeh,Nazila Garousi

doi:10.1007/s40519-021-01269-3

Abstract

PurposeThe 2019 novel coronavirus (COVID-19) is an emerging pandemic, with a disease course varying from asymptomatic infection to critical disease resulting to death. Recognition of prognostic factors is essential because of its growing prevalence and high clinical costs. This meta-analysis aimed to evaluate the global prevalence of obesity in COVID-19 patients and to investigate whether obesity is a risk factor for the COVID-19, COVID-19 severity, and its poor clinical outcomes including hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, and mortality.MethodsThe study protocol was registered in PROSPERO (CRD42020203386). A systematic search of Scopus, Medline, and Web of Sciences was conducted from 31 December 2019 to 1 June 2020 to find pertinent studies. After selection, 54 studies from 10 different countries were included in the quantitative analyses. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the associations.ResultsThe prevalence of obesity was 33% (95% CI 30.0%–35.0%) among patients with COVID-19. Obesity was significantly associated with susceptibility to COVID-19 (OR = 2.42, 95% CI 1.58–3.70; moderate certainty) and COVID-19 severity (OR = 1.62, 95% CI 1.48–1.76; low certainty). Furthermore, obesity was a significant risk factor for hospitalization (OR = 1.75, 95% CI 1.47–2.09; very low certainty), mechanical ventilation (OR = 2.24, 95% CI 1.70–2.94; low certainty), intensive care unit (ICU) admission (OR = 1.75, 95% CI 1.38–2.22; low certainty), and death (OR = 1.23, 95% CI 1.06–1.41; low certainty) in COVID-19 patients. In the subgroup analyses, these associations were supported by the majority of subgroups.ConclusionObesity is associated with COVID-19, need for hospitalization, mechanical ventilation, ICU admission, and death due to COVID-19.Level of evidenceLevel I, systematic reviews and meta-analyses.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40519-021-01269-3.

Highlights

MethodsThe 2019 novel coronavirus (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a viral disease which first diagnosed in late 2019 in Wuhan City of Hubei Province of China, and it is spreading rapidly [1]
Since obesity is associated with a mild chronic inflammatory condition [4] and immune dysfunction [5], evidence suggests that obesity may be a risk factor [6], but the findings are still insufficient in this regard
Participants were from two ethnicities (Caucasian and East-Asian) from 10 different countries, including Mexico, United Kingdom (UK), Italy, United States of America (USA), France, China, Bolivia, Spain, Germany, and Singapore

Summary

Introduction

MethodsThe 2019 novel coronavirus (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a viral disease which first diagnosed in late 2019 in Wuhan City of Hubei Province of China, and it is spreading rapidly [1]. Recent evidence suggests that the severity of clinical manifestations and mortality rate of the disease varies from person to person and depends on a variety of factors [3]. This study showed that with increasing BMI, the severity of the disease and the proportion of patients who need mechanical ventilation increase but no difference in mortality rates was observed between obese and non-obese patients [7]. Findings in Italy revealed that the need for intensive care and the use of a ventilator in overweight and obese patients, despite their younger age, is higher than in normal weight patients [8]. A cross-sectional study in Mexico demonstrated that obesity is one of the most critical risk factors for coronavirus respiratory infection [9]. Wu et al did not considered a statistically significant relationship between obesity and the severity of COVID-19 [10]

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