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Meta-Analysis
. 2021 Aug 4;21(1):1505.
doi: 10.1186/s12889-021-11546-6.

Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis

Zixin Cai #  1 , Yan Yang #  1 , Jingjing Zhang  2
Affiliations
Meta-Analysis

Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis

Zixin Cai et al. BMC Public Health. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has led to global research to predict those who are at greatest risk of developing severe disease and mortality. The aim of this meta-analysis was to determine the associations between obesity and the severity of and mortality due to COVID-19.

Methods: We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies evaluating the associations of obesity with COVID-19. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Meta-regression analyses were conducted to estimate regression coefficients.

Results: Forty-six studies involving 625,153 patients were included. Compared with nonobese patients, obese patients had a significantly increased risk of infection. (OR 2.73, 95% CI 1.53-4.87; I2 = 96.8%), hospitalization (OR 1.72, 95% CI 1.55-1.92; I2 = 47.4%), clinically severe disease (OR 3.81, 95% CI 1.97-7.35; I2 = 57.4%), mechanical ventilation (OR 1.66, 95% CI 1.42-1.94; I2 = 41.3%), intensive care unit (ICU) admission (OR 2.25, 95% CI 1.55-3.27; I2 = 71.5%), and mortality (OR 1.61, 95% CI 1.29-2.01; I2 = 83.1%).

Conclusion: Patients with obesity may have a greater risk of infection, hospitalization, clinically severe disease, mechanical ventilation, ICU admission, and mortality due to COVID-19. Therefore, it is important to increase awareness of these associations with obesity in COVID-19 patients.

Keywords: COVID-19; Mortality; Obesity; Predict; Severity.

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Conflict of interest statement

All authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram
Fig. 2
Fig. 2
Forest plot comparing the odds of infection with SARS-CoV-2 between obese and nonobese patients
Fig. 3
Fig. 3
Forest plot comparing the odds of hospitalization for COVID-19 between obese and nonobese patients
Fig. 4
Fig. 4
Forest plot comparing the odds of severe COVID-19 between obese and nonobese patients
Fig. 5
Fig. 5
Forest plot comparing the odds of mechanical ventilation due to COVID-19 between obese and nonobese patients
Fig. 6
Fig. 6
Forest plot comparing the odds of ICU admission due to COVID-19 between obese and nonobese patients
Fig. 7
Fig. 7
Forest plot comparing the odds of mortality due to COVID-19 between obese and nonobese patients
Fig. 8
Fig. 8
Funnel plot for hospitalization (A), severe disease (B), mechanical ventilation (C), ICU admission (D), and mortality (E) between obese and non-obese patients
Fig. 9
Fig. 9
Sensitivity analysis for hospitalization (A), severe disease (B), mechanical ventilation (C), ICU admission (D), and mortality (E) between obese and nonobese patients
See this image and copyright information in PMC

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