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Meta-Analysis
. 2021 Jun:43:163-168.
doi: 10.1016/j.clnesp.2021.04.001. Epub 2021 Apr 9.

Visceral adiposity, subcutaneous adiposity, and severe coronavirus disease-2019 (COVID-19): Systematic review and meta-analysis

Raymond Pranata  1 , Michael Anthonius Lim  2 , Ian Huang  3 , Emir Yonas  4 , Joshua Henrina  5 , Rachel Vania  6 , Antonia Anna Lukito  7 , Sally Aman Nasution  8 , Idrus Alwi  9 , Bambang Budi Siswanto  10
Affiliations
Meta-Analysis

Visceral adiposity, subcutaneous adiposity, and severe coronavirus disease-2019 (COVID-19): Systematic review and meta-analysis

Raymond Pranata et al. Clin Nutr ESPEN. 2021 Jun.

Abstract

Background and aims: Body mass index (BMI) has previously been shown to increase mortality and disease severity in patients with COVID-19, but the pooled effect estimate was heterogeneous. Although BMI is widely used as an indicator, it cannot distinguish visceral from subcutaneous fat. This systematic review and meta-analysis aimed to investigate the association between visceral adiposity, subcutaneous fat, and severe COVID-19.

Methods: We performed a systematic literature search using the databases: PubMed, Embase, and EuropePMC. Data on visceral fat area (VTA), subcutaneous fat area (SFA), and total fat area (TFA) were collected. The outcome of interest was severe COVID-19. We used a REML random-effects model to pool the mean differences and odds ratio (OR).

Results: There were 5 studies comprising of 539 patients. Patients with severe COVID-19 have a higher VTA (mean difference 41.7 cm2 [27.0, 56.4], p < 0.001; I2: 0%) and TFA (mean difference 64.6 cm2 [26.2, 103.1], p = 0.001; I2: 0%). There was no significant difference in terms of SFA between patients with severe and non-severe COVID-19 (mean difference 9.3 cm2 [-4.9, 23.4], p = 0.199; I2: 1.2%). Pooled ORs showed that VTA was associated with severe COVID-19 (OR 1.9 [1.1, 2.2], p = 0.002; I2: 49.3%).

Conclusion: Visceral adiposity was associated with increased COVID-19 severity, while subcutaneous adiposity was not.

Prospero id: CRD42020215876.

Keywords: Adiposity; Coronavirus; Obesity; Visceral fat; Visceral fat area.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart.
Fig. 2
Fig. 2
Mean difference in visceral fat area between severe and non-severe COVID-19.
Fig. 3
Fig. 3
Mean difference in subcutaneous fat area between severe and non-severe COVID-19.
Fig. 4
Fig. 4
Mean difference in total fat area between severe and non-severe COVID-19.
Fig. 5
Fig. 5
Visceral fat area and risk of severe COVID-19.
See this image and copyright information in PMC

References

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