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Meta-Analysis
. 2020 Oct;21(10):e13095.
doi: 10.1111/obr.13095. Epub 2020 Jul 19.

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

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 Hartmann  6 , Gabriella Pár  7 , Bálint Erőss  1   2 , Zsolt Molnár  1   2   8 , Péter Hegyi  1   2 , Andrea Szentesi  1   2   9 ; KETLAK Study Group
Affiliations
Meta-Analysis

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

Mária Földi et al. Obes Rev. 2020 Oct.

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.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting in Systematic Reviews and Meta‐analyses (PRISMA) flowchart showing the selection process
FIGURE 2
FIGURE 2
Odds ratios for intensive care unit admission in patients with obesity versus patients without obesity. BMI, body mass index; CI, confidence interval; ICU, intensive care unit
FIGURE 3
FIGURE 3
Odds ratios for invasive mechanical ventilation (IMV) in patients with obesity versus patients without obesity. CI, confidence interval
FIGURE 4
FIGURE 4
Odds ratios for invasive mechanical ventilation (IMV) between patient groups with different BMI ranges (<25, 25‐30, 30‐35 and ≥35). BMI = body mass index, CI = confidence interval
See this image and copyright information in PMC

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