Obesity is a risk factor for developing critical condition in COVID-19 patients: A systematic review and meta-analysis

Mária Földi; Nelli Farkas; Szabolcs Kiss; Noémi Zádori; Szilárd Váncsa; Lajos Szakó; Fanni Dembrovszky; Margit Solymár; Eszter Bartalis; Zsolt Szakács; Petra Hartmann; Gabriella Pár; Bálint Erőss; Zsolt Molnár; Péter Hegyi; Andrea Szentesi; KETLAK Study Group

doi:10.1111/obr.13095

Obesity is a risk factor for developing critical condition in COVID-19 patients: A systematic review and meta-analysis

Obes Rev. 2020 Oct;21(10):e13095. doi: 10.1111/obr.13095. Epub 2020 Jul 19.

Authors

Mária Földi^{1

2

3}, Nelli Farkas^{1

2

4}, Szabolcs Kiss^{1

2

3}, Noémi Zádori^{1

2}, Szilárd Váncsa^{1

2}, Lajos Szakó^{1

2}, Fanni Dembrovszky^{1

2}, Margit Solymár^{1

2}, Eszter Bartalis^{1

5}, Zsolt Szakács^{1

2}, Petra Hartmann⁶, Gabriella Pár⁷, Bálint Erőss^{1

2}, Zsolt Molnár^{1

2

8}, Péter Hegyi^{1

2}, Andrea Szentesi^{1

2

9}; KETLAK Study Group

Affiliations

¹ Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
² Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
³ Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary.
⁴ Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary.
⁵ Faculty of Medicine, University of Medicine, Pharmacy, Science and Technology of Targu Mures, Targu Mures, Romania.
⁶ Institute of Surgical Research, University of Szeged, Szeged, Hungary.
⁷ Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary.
⁸ Department of Anesthesiology and Intensive Therapy, Poznan University for Medical Sciences, Poznan, Poland.
⁹ First Department of Medicine, University of Szeged, Szeged, Hungary.

Abstract

The 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.

Keywords: COVID-19; intensive care; mechanical ventilation; obesity.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Betacoronavirus*
COVID-19
Coronavirus Infections / complications*
Critical Illness
Humans
Obesity / complications*
Pandemics
Pneumonia, Viral / complications*
Risk Factors
SARS-CoV-2
Severity of Illness Index

Abstract

Publication types

MeSH terms

Grants and funding