Obesity is associated with increased severity of disease in COVID-19 pneumonia: a systematic review and meta-analysis
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(2020) 25:64 Chu et al. Eur J Med Res https://doi.org/10.1186/s40001-020-00464-9
Open Access
REVIEW
Obesity is associated with increased severity of disease in COVID‑19 pneumonia: a systematic review and meta‑analysis Yanan Chu1, Jinxiu Yang1, Jiaran Shi1, Pingping Zhang1,2 and Xingxiang Wang1*
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/m2, 95% CI [2.00 to 2.96 kg/m2]). 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, Obesity, Poor outcomes, Meta-analysis Introduction In early December 2019, the rapid propagation of a novel coronavirus broke out in Wuhan, Hubei, China, and caused a highly infectious serious acute respiratory
*Correspondence: [email protected] 1 Department of Cardiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310006, Zhejiang, China Full list of author information is available at the end of the article
syndrome named coronavirus disease 2019 (COVID19) [1]. COVID-19 causes high morbidity and mortality worldwide, and the World Health Organization (WHO) officially declared it a pandemic [2]. By 25 May 2020, COVID-19 had caused 5,941,223 confirmed cases and 366,601 related fatalities worldwide [3]. Severe acute respiratory sy
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