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Meta-Analysis
. 2020 Dec 21:11:595109.
doi: 10.3389/fendo.2020.595109. eCollection 2020.

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

Xue Zhao  1 , Xiaokun Gang  1 , Guangyu He  1 , Zhuo Li  1 , You Lv  1 , Qing Han  2 , Guixia Wang  1
Affiliations
Meta-Analysis

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

Xue Zhao et al. Front Endocrinol (Lausanne). .

Abstract

Since December 2019, COVID-19 has aroused global attention. Studies show the link between obesity and severe outcome of influenza and COVID-19. Thus, we aimed to compare the impacts of obesity on the severity and mortality of influenza and COVID-19 by performing a meta-analysis. A systematic search was performed in MEDLINE, EMASE, ClinicalTrials.gov, and Web of Science from January 2009 to July 2020. The protocol was registered onto PROSPERO (CRD42020201461). After selection, 46 studies were included in this meta-analysis. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed. We found obesity was a risk factor for the severity and mortality of influenza (ORsevere outcome = 1.56, CI: 1.28-1.90; ORmortality = 1.99, CI: 1.15-3.46). For COVID-19, obesity was a significant risk factor only for severe outcome (OR = 2.07, CI: 1.53-2.81) but not for mortality (OR = 1.57, CI: 0.85-2.90). Compared with obesity, morbid obesity was linked with a higher risk for the severity and mortality of both influenza (OR = 1.40, CI: 1.10-1.79) and COVID-19 (OR = 3.76, CI: 2.67-5.28). Thus, obesity should be recommended as a risk factor for the prognosis assessment of COVID-19. Special monitoring and earlier treatment should be implemented in patients with obesity and COVID-19.

Keywords: COVID-19; influenza; mortality; obesity; severe outcome.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart on the literature selection process in this meta-analysis.
Figure 2
Figure 2
Odds ratios for influenza infection in patients with obesity versus patients without obesity.
Figure 3
Figure 3
Odds ratios for influenza-induced hospitalization in patients with obesity and morbid obesity.
Figure 4
Figure 4
Odds ratios for severe outcome or admission to ICU in patients with obesity and influenza or COVID-19.
Figure 5
Figure 5
Subgroup analysis (by region) on the effects of obesity on the severity and mortality of COVID-19.
Figure 6
Figure 6
Odds ratios for the mortality of patients with obesity and influenza or COVID-19.
Figure 7
Figure 7
Odds ratios for severe outcome and mortality in patients with morbid obesity and influenza or COVID-19.
See this image and copyright information in PMC

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