Effect of increased BMI and obesity on the outcome of COVID-19 adult patients: A systematic review and meta-analysis

• Published in: Diabetes & metabolic syndrome clinical research & reviews Vol. 14; no. 6; pp. 1897 - 1904
• Main Authors: Soeroto, Arto Yuwono, Soetedjo, Nanny Natalia, Purwiga, Aga, Santoso, Prayudi, Kulsum, Iceu Dimas, Suryadinata, Hendarsyah, Ferdian, Ferdy
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-11-2020; Diabetes India. Published by Elsevier Ltd
• Subjects: Age Factors; Body Mass Index; Covid-19; COVID-19 - epidemiology; COVID-19 - mortality; COVID-19 - therapy; Diabetes Mellitus, Type 2 - epidemiology; Hospitalization - statistics & numerical data; Humans; Hypertension - epidemiology; Intensive Care Units - statistics & numerical data; Obesity; Obesity - epidemiology; Poor outcome; Respiration, Artificial - statistics & numerical data; Respiratory Distress Syndrome - epidemiology; Respiratory Distress Syndrome - mortality; Respiratory Distress Syndrome - therapy; SARS-CoV-2; Severity of Illness Index; Sex Factors; Body mass index; Obesity; Covid-19; Poor outcome
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2020.09.029

Corona virus diseases 2019 (COVID-19) pandemic spread rapidly. Growing evidences that overweight and obesity which extent nearly a third of the world population were associated with severe COVID-19. This study aimed to explore the association and risk of increased BMI and obesity with composite poor outcome in COVID-19 adult patients.
We conducted a systematic literature search from PubMed and Embase database. We included all original research articles in COVID-19 adult patients and obesity based on classification of Body Mass Index (BMI) and composite poor outcome which consist of ICU admission, ARDS, severe COVID-19, use of mechanical ventilation, hospital admission, and mortality.
Sixteen studies were included in meta-analysis with 9 studies presented BMI as continuous outcome and 10 studies presented BMI as dichotomous outcome (cut-off ≥30 kg/m2). COVID-19 patients with composite poor outcome had higher BMI with mean difference 1.12 (95% CI, 0.67–1.57, P < 0.001). Meanwhile, obesity was associated with composite poor outcome with odds ratio (OR) = 1.78 (95% CI, 1.25–2.54, P < 0.001) Multivariate meta-regression showed the association between BMI and obesity on composite poor outcome were affected by age, gender, DM type 2, and hypertension.
Obesity is a risk factor of composite poor outcome of COVID-19. On the other hand, COVID-19 patients with composite poor outcome have higher BMI. BMI is an important routine procedure that should always be assessed in the management of COVID-19 patients and special attention should be given to patients with obesity.
•Adult COVID-19 patients with poor outcome had higher body mass index (BMI) with mean difference of 1.12 kg/m2 (P < 0.001).•Obesity (BMI ≥30 kg/m2) was associated with composite poor outcome with OR = 1.78 (P < 0.001).•Association between composite poor outcome and BMI was affected by age, gender, type 2 diabetes, and hypertension.