Obesity as a predictor for a poor prognosis of COVID-19: A systematic review

Abstract

Background and aims: COVID-19 is an emerging pandemic due to droplet infection of 2019-novel coronavirus (2019-nCoV). Due to its rapid transmission and high case-fatality rate, recognition of its risk and prognostic factor is important. Obesity has been associated with impaired immune system, increasing the susceptibility for 2019-nCoV infection. We aimed to study the impact of obesity to the prognosis and disease severity of COVID-19. Methods: A systematic search and handsearching was conducted in four databases: Cochrane, MEDLINE, EMBASE, and PubMed. The identified articles were screened using the chosen eligibility criteria. We obtained three retrospective cohort studies (Wu J et al., Lighter J et al., and Simonnet A et al.) to be critically appraised using Newcastle Ottawa Scale. Results: The findings of all included studies were consistent in stating the contribution of obesity as a risk factor to increase the requirement for advanced medical care. Study with the highest quality, Simonnet A et al., reported an increase need of invasive mechanical ventilation in COVID-19 patients with body mass index higher than 35 kg/m 2 , OR: 7.36 (1.63e33.14; p ¼ 0.021). This is associated with a higher mortality rate in obese population infected with COVID-19. Conclusion: Obesity is an independent risk and prognostic factor for the disease severity and the requirement of advanced medical care in COVID-19. This systematic review highlights a particularly vulnerable group e obese, and emphasises on the importance of treatment aggression and disease prevention in this population group.

WITHDRAWN: The Negative Impact of Obesity on the Occurrence and Prognosis of the 2019 Novel Coronavirus (COVID-19) Disease: A Systematic Review and Meta-Analysis

“…That review found that obesity was associated with the increasing prevalence of hospitalization (average of 20.4%) and greater lethality (average of 20.4%) in the patient with COVID-19 (77). The contribution of obesity to diseases severity and the requirement of advanced medical care in COVID-19 has been also stated in another initial review that only included 3 studies (78). Our study also further added to a meta-analysis that showed obesity is a risk factor for both ICU admission and mechanical ventilation requirement in COVID-19 patients (11).…”

Predictive value of CT in the short-term mortality of Coronavirus Disease 2019 (COVID-19) pneumonia in nonelderly patients: A case-control study

“…A dedicated etiologic study with larger number of cases and in different age groups is warranted to investigate the predictability of this factor. Obesity has been reported as an independent risk and prognostic factor for the disease severity and the requirement of advanced medical care in COVID-19 [ 18 ]. Klang et al concluded that morbid obesity is an independent risk factor for mortality of COVID-19 in hospitalized patients under the age of 50 years [ 19 ], the same age range as our study.…”

A systematic review of etiology, epidemiology, clinical manifestations, image findings, and medication of 2019 Corona Virus Disease-19 in Wuhan, China

“…The prognosis factors of COVID-19 patients include age, [ 50 , 58 ] sex, [ 50 , 58 ] obesity, [ 59 ] smoking, [ 55 , 60 – 62 ] C-reactive protein (CRP), D-dimer, and lymphocyte count. [ 50 ]…”

“…[ 63 ] Concerning obesity, it contributes to the increased risk and poorer prognosis of COVID-19. [ 59 ] As for smoking, it is very likely to be related to the negative progression and adverse consequences of COVID-19. [ 55 , 60 – 62 ]…”