Prevalence of Obesity and Its Impact on Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis

Background and Objective Obesity has been reported as a risk factor for adverse outcomes in COVID-19. However, available studies presenting data on obesity prevalence in patients with COVID-19 have conflicting results. The objective of this systematic review and meta-analysis is to evaluate the prevalence of obesity in these patients and to stratify the estimates by illness severity. Methods We performed a literature search with the use of Medline/PubMed and Google Scholar database from December 1, 2019 to June 27, 2020 and systematically reviewed studies reporting the number of obese patients with real-time reverse transcriptase polymerase chain reaction (rRT-PCR)-confirmed SARS-CoV-2 infection. Results Nineteen studies were identified. The pooled obesity prevalence rates were 0.32 (95% CI: 0.24-0.41) in hospitalized patients, 0.41 (95% CI: 0.36-0.45) in patients admitted to intensive care unit, 0.43 (95% CI: 0.36-0.51) in patients needing invasive mechanic ventilation (IMV), and 0.33 (95% CI: 0.26-0.41) in those who died. Obesity was associated with a higher risk for hospitalization [Odds ratio (OR): 1.3, 95% CI: 1.00-1.69; I-2 52%, p = 0.05], ICU admission (OR: 1.51, 95% CI: 1.16-1.97; I-2 72%, p = 0.002), and IMV requirement (OR: 1.77, 95% CI: 1.34-2.35; I-2 0%, p < 0.001). The increase in risk of death did not reach statistical significance (OR: 1.28, 95% CI: 0.76-2.16, p = 0.35) which might be due to obesity survival paradox and/or unidentified factors. Conclusions Our data indicate that obese subjects may be at higher risk for serious illness if infected and obesity may play a role in the progression of COVID-19.

Automated summary

This study analyzed the prevalence of obesity in COVID-19 patients and found an association between obesity and increased risk of hospitalization, ICU admission, and need for invasive mechanical ventilation. The study suggests that obesity may contribute to the progression of COVID-19 and increase the risk of serious illness in infected individuals.