Effect of obesity and body mass index on coronavirus disease 2019 severity: A systematic review and meta‐analysis

• Published in: Obesity reviews 2020-11, Vol.21 (11), p.e13089-n/a
• Main Authors: Chang, Tu‐Hsuan, Chou, Chia‐Ching, Chang, Luan‐Yin
• Format: Article
• Language: English
• Subjects: Betacoronavirus; BMI; Body mass; Body Mass Index; Body size; Coronaviridae; Coronavirus Infections - complications; Coronavirus Infections - physiopathology; Coronaviruses; COVID-19; Health risks; Heterogeneity; Humans; Mechanical ventilation; Meta-analysis; Obesity; Obesity - complications; Obesity - physiopathology; Pandemics; Physicians; Pneumonia, Viral - complications; Pneumonia, Viral - physiopathology; SARS-CoV-2; severe disease; Severity of Illness Index; Systematic review; Ventilation; Viral diseases
• ISSN: 1467-7881; 1467-789X
• DOI: 10.1111/obr.13089

Summary We conducted a systematic review of observational studies to examine the effects of body mass index (BMI) and obesity (BMI ≥ 30 kg/m2) on coronavirus disease 2019 (COVID‐19). Medline, Embase, and the Cochrane Library were searched. Sixteen articles were finally included in the meta‐analysis, and a random effects model was used. BMI was found to be higher in patients with severe disease than in those with mild or moderate disease (MD 1.6, 95% CI, 0.8–2.4; p = .0002) in China; however, the heterogeneity was high (I2 = 75%). Elevated BMI was associated with invasive mechanical ventilation (IMV) use (MD 4.1, 95% CI, 2.1–6.1; p < .0001) in Western countries, and this result was consistent across studies (I2 = 0%). Additionally, there were increased odds ratios of IMV use (OR 2.0, 95% CI, 1.4–2.9; p < .0001) and hospitalization (OR 1.4, 95% CI, 1.3–1.60; p < .00001) in patients with obesity. There was no substantial heterogeneity (I2 = 0%). In conclusion, obesity or high BMI increased the risk of hospitalization, severe disease and invasive mechanical ventilation in COVID‐19. Physicians must be alert to these early indicators to identify critical patients.