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

• Published in: Clinical nutrition ESPEN Vol. 43; pp. 163 - 168
• Main Authors: Pranata, Raymond, Lim, Michael Anthonius, Huang, Ian, Yonas, Emir, Henrina, Joshua, Vania, Rachel, Lukito, Antonia Anna, Nasution, Sally Aman, Alwi, Idrus, Siswanto, Bambang Budi
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-06-2021; European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd
• Subjects: Adiposity; Coronavirus; Meta-Analysis; Obesity; Visceral fat; Visceral fat area; Visceral fat; Obesity; Visceral fat area; Coronavirus; Adiposity
• ISSN: 2405-4577; 2405-4577
• DOI: 10.1016/j.clnesp.2021.04.001

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.
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).
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%).
Visceral adiposity was associated with increased COVID-19 severity, while subcutaneous adiposity was not.
CRD42020215876.