Obesity is associated with severe COVID-19 but not death: a dose-response meta-analysis

Epidemiol Infect. 2021 Jan 5:149:e144. doi: 10.1017/S0950268820003179.

Abstract

The coronavirus disease 2019 (COVID-19) epidemic is spreading globally. Studies revealed that obesity may affect the progression and prognosis of COVID-19 patients. The aim of the meta-analysis is to identify the prevalence and impact of obesity on COVID-19. Studies on obese COVID-19 patients were obtained by searching PubMed, Cochrane Library databases and Web of Science databases, up to date to 5 June 2020. And the prevalence rate and the odds ratio (OR) of obesity with 95% confidence interval (CI) were used as comprehensive indicators for analysis using a random-effects model. A total of 6081 patients in 11 studies were included. The prevalence of obesity in patients with COVID-19 was 30% (95% CI 21-39%). Obese patients were 1.79 times more likely to develop severe COVID-19 than non-obese patients (OR 1.79, 95% CI 1.52-2.11, P < 0.0001, I2 = 0%). However obesity was not associated with death in COVID-19 patients (OR 1.05, 95% CI 0.65-1.71, P = 0.84, I2 = 66.6%). In dose-response analysis, it was estimated that COVID-19 patients had a 16% increased risk of invasive mechanical ventilation (OR 1.16, 95% CI 1.10-1.23, P < 0.0001) and a 20% increased risk of admission to ICU (OR 1.20, 95% CI 1.11-1.30, P < 0.0001) per 5 kg/m2 increase in BMI. In conclusion, obesity in COVID-19 patients is associated with severity, but not mortality.

Keywords: COVID-19; meta-analysis; mortality; obesity; severity.

Publication types

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

MeSH terms

  • Body Mass Index
  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • COVID-19 / mortality
  • Hospitalization / statistics & numerical data
  • Humans
  • Obesity / complications*
  • Obesity / epidemiology
  • Prevalence
  • Risk Factors
  • Severity of Illness Index