Nafiye Helvaci1, Nesrin Damla Eyupoglu2, Erdem Karabulut3, Bulent Okan Yildiz2. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hitit University School of Medicine, Corum, Turkey. 2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey. 3. Department of Biostatistics, School of Medicine, Hacettepe University, Ankara, Turkey.
Abstract
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; I2 52%, p = 0.05], ICU admission (OR: 1.51, 95% CI: 1.16-1.97; I2 72%, p = 0.002), and IMV requirement (OR: 1.77, 95% CI: 1.34-2.35; I2 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.
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 obesepatients 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; I2 52%, p = 0.05], ICU admission (OR: 1.51, 95% CI: 1.16-1.97; I2 72%, p = 0.002), and IMV requirement (OR: 1.77, 95% CI: 1.34-2.35; I2 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.
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