Obesity a predictor of outcomes of COVID‐19 hospitalized patients—A systematic review and meta‐analysis

Abstract

Background COVID‐19 pandemic is a global health crisis. Very few studies have reported association between obesity and severity of COVID‐19. In this meta‐analysis, we assessed the association of obesity and outcomes in COVID‐19 hospitalized patients. Methods Data from observational studies describing the obesity or body mass index (BMI) and outcomes of COVID‐19 hospitalized patients from December 1, 2019, to August 15, 2020, was extracted following PRISMA guidelines with a consensus of two independent reviewers. Adverse outcomes defined as intensive care units (ICU), oxygen saturation <90%, invasive mechanical ventilation (IMV), severe disease and in‐hospital mortality. The odds ratio (OR) and 95% confidence interval (95%CI) were obtained and forest plots were created using random‐effects models. Results A total of 10 studies with 10,233 confirmed COVID‐19 patients were included. The overall prevalence of obesity in our study was 33.9% (3473/10,233). In meta‐analysis, COVID‐19 patient with obesity had higher odds of poor outcomes compared to better outcomes with a pooled OR of 1.88 (95%CI:1.25–2.80; p=0.002), with 86% heterogeneity between studies (p<0.00001). Conclusion Our study suggests a significant association between obesity and COVID‐19 severity and poor outcomes. Our results findings may have important suggestions for the clinical management and future research of obesity and COVID‐19. This article is protected by copyright. All rights reserved.

Associations of Body Mass Index with Ventilation Management and Clinical Outcomes in Invasively Ventilated Patients with ARDS Related to COVID-19—Insights from the PRoVENT-COVID Study

“…The effects of BMI on mortality in the current study contrast with the findings of one meta-analysis showing a significant association between obesity and COVID-19 severity and outcome [ 24 ]. That meta-analysis, however, accepted studies that included patients other than those receiving invasive ventilation in the ICU; the impact of BMI on outcome could differ between ventilated and non-ventilated COVID-19 patients.…”

Predictors of Worse Prognosis in Young and Middle-Aged Adults Hospitalized with COVID-19 Pneumonia: A Multi-Center Italian Study (COVID-UNDER50)

“…The prevalence of obesity in our hospitalized cohort (25.9%) was higher than that reported by age class in Italy (around 6% in subjects aged 18–45 years in 2019) [ 13 ], suggesting that this might be a risk factor for both hospitalization and a more severe disease in the young also. Our results are in line with previous observations in the adult COVID-19 population, as summarized by meta-analyses of data, showing increased risks of hospitalization, severe disease, the need for MV and mortality in obese patients, with different levels of risk excess [ 14 , 15 , 16 , 17 ]. However, in our cohort, obesity, the heaviest independent determinant for MV, was not associated with a higher mortality risk.…”

Prevalence of Obesity and Its Impact on Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis

“…In the fast-moving field of COVID-19, other meta-analyses have also assessed the relationship between this disorder and obesity. Using various inclusion criteria and definitions for the outcome variables, most of these meta-analyses indicated that in patients with COVID-19, obesity is significantly related to increased risk of severe disease and composite poor outcomes with reported ORs varying from 1.39 to 2.35 (33)(34)(35)(36)(37)(38)(39)(40)(41). A few meta-analyses presenting separate analyses for different outcomes reported increased risk of hospitalization with ORs varying from 1.4 to 2.13 (34,42,43), ICU admission with ORs varying from 1.21 to 1.74 (34,43,44), and IMV requirement with ORs varying from 1.66 to 2.29 (34,36,(42)(43)(44) in obese patients with COVID-19.…”