Obesity or increased body mass index and the risk of severe outcomes in patients with COVID-19

Abstract

Background: To assess the effect of obesity or a high body mass index (BMI) on the risk of severe outcomes in patients with coronavirus disease 2019 (COVID-19). Methods: Studies on the relationship between BMI or obesity and COVID-19 since December 2019. The odds ratio (OR) and weighted mean difference (WMD) with their 95% confidence intervals (CIs) were used to assess the effect size. Results: BMI was significantly increased in COVID-19 patients with severe illness (WMD: 1.18; 95% CI: 0.42–1.93), who were admitted to an intensive care unit (ICU) (WMD: 1.46; 95% CI: 0.96–1.97), who required invasive mechanical ventilation (IMV) (WMD: 2.70, 95% CI: 1.05–4.35) and who died (WMD: 0.91, 95% CI: 0.02–1.80). In Western countries, obesity (BMI of ≥30 kg/m 2 ) increased the risk of hospitalization (OR: 2.08; 95% CI: 1.22–3.54), admission to an ICU (OR: 1.54; 95% CI: 1.29–1.84), need for IMV (OR: 1.73, 95% CI: 1.38–2.17), and mortality (OR: 1.43; 95% CI: 1.17–1.74) of patients with COVID-19. In the Asian population, obesity (BMI of ≥28 kg/m 2 ) increased the risk of severe illness (OR: 3.14; 95% CI: 1.83–5.38). Compared with patients with COVID-19 and a BMI of <25 kg/m 2 , those with a BMI of 25–30 kg/m 2 and ≥30 kg/m 2 had a higher risk of need for IMV (OR: 2.19, 95% CI: 1.30–3.69 and OR: 3.04; 95% CI: 1.76–5.28, respectively). The risk of ICU admission in patients with COVID-19 and a BMI of ≥30 kg/m 2 was significantly higher than in those with a BMI of 25–30 kg/m 2 (OR: 1.49; 95% CI: 1.00–2.21). Conclusion: As BMI increased, the risks of hospitalization, ICU admission, and need for IMV increased, especially in COVID-19 patients with obesity. Ethics and dissemination: This systematic review and meta-analysis does not require an ethics approval as it does not collect any primary data from patients.

Applying the behavior change wheel to identify pandemic-related attitudes and feelings about physical activity as predictors of physical activity level among university students in Indonesia during the COVID-19 pandemic

“…However, our current study contradicts the majority of previous studies showing that overweight and obese adults were associated with lower PA levels (Haynes et al, 2018). Pandemic situations could increase their awareness of the importance of PA during the pandemic since being overweight or obese is one of the important risk factors for COVID-19 severity (Pu et al, 2020;Robertson et al, 2022;Yang et al, 2022). In addition, their perception of having more spare time during the pandemic could also facilitate them to do more PA (Robertson et al, 2022).…”

COVID-19: Reducing the risk via diet and lifestyle

“…These findings were supported by meta-analyses of data from Europe, Asia and North America [28] , [29] , [30] . Recent studies have again confirmed these findings, with a 2022 meta-analysis of 57 studies finding a doubling of hospitalisation risk in Western countries and a three-fold increased risk of severe disease in Asian populations among obese individuals [31] .…”

Effects of nutrients on immunomodulation in patients with severe COVID-19: Current knowledge

“…Food can influence cytokine gene expression levels and thus modulate inflammation and oxidative stress[ 25 ]. Cytokines such as tumor necrosis factor (TNF)-alpha and IL-6 when produced excessively have been related to dysregulation of the inflammatory response and stimulation of cytokine storms[ 26 ]. Furthermore, increased adipose tissue contributes to greater leptin production, which is related to macrophage activation and proliferation, while reduced adiponectin levels decrease the synthesis of anti-inflammatory compounds.…”