Obesity as a predictor for a poor prognosis of COVID-19: A systematic review

Diabetes Metab Syndr. 2020 Jul-Aug;14(4):655-659. doi: 10.1016/j.dsx.2020.05.020. Epub 2020 May 12.

Abstract

Background and aims: COVID-19 is an emerging pandemic due to droplet infection of 2019-novel coronavirus (2019-nCoV). Due to its rapid transmission and high case-fatality rate, recognition of its risk and prognostic factor is important. Obesity has been associated with impaired immune system, increasing the susceptibility for 2019-nCoV infection. We aimed to study the impact of obesity to the prognosis and disease severity of COVID-19.

Methods: A systematic search and handsearching was conducted in four databases: Cochrane, MEDLINE, EMBASE, and PubMed. The identified articles were screened using the chosen eligibility criteria. We obtained three retrospective cohort studies (Wu J et al., Lighter J et al., and Simonnet A et al.) to be critically appraised using Newcastle Ottawa Scale.

Results: The findings of all included studies were consistent in stating the contribution of obesity as a risk factor to increase the requirement for advanced medical care. Study with the highest quality, Simonnet A et al., reported an increase need of invasive mechanical ventilation in COVID-19 patients with body mass index higher than 35 kg/m2, OR: 7.36 (1.63-33.14; p = 0.021). This is associated with a higher mortality rate in obese population infected with COVID-19.

Conclusion: Obesity is an independent risk and prognostic factor for the disease severity and the requirement of advanced medical care in COVID-19. This systematic review highlights a particularly vulnerable group - obese, and emphasises on the importance of treatment aggression and disease prevention in this population group.

Keywords: COVID-19; Obesity; Predictor; Prognosis.

Publication types

  • Systematic Review

MeSH terms

  • Betacoronavirus / pathogenicity
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / immunology
  • Coronavirus Infections / mortality
  • Coronavirus Infections / physiopathology*
  • Humans
  • Obesity / complications*
  • Obesity / immunology
  • Obesity / mortality
  • Obesity / physiopathology*
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / physiopathology*
  • Prognosis
  • SARS-CoV-2