The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and meta-analysis

Abstract

Purpose The 2019 novel coronavirus (COVID-19) is an emerging pandemic, with a disease course varying from asymptomatic infection to critical disease resulting to death. Recognition of prognostic factors is essential because of its growing prevalence and high clinical costs. This meta-analysis aimed to evaluate the global prevalence of obesity in COVID-19 patients and to investigate whether obesity is a risk factor for the COVID-19, COVID-19 severity, and its poor clinical outcomes including hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, and mortality. Methods The study protocol was registered in PROSPERO (CRD42020203386). A systematic search of Scopus, Medline, and Web of Sciences was conducted from 31 December 2019 to 1 June 2020 to find pertinent studies. After selection, 54 studies from 10 different countries were included in the quantitative analyses. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the associations. Results The prevalence of obesity was 33% (95% CI 30.0%-35.0%) among patients with COVID-19. Obesity was significantly associated with susceptibility to COVID-19 (OR = 2.42, 95% CI 1.58-3.70; moderate certainty) and COVID-19 severity (OR = 1.62, 95% CI 1.48-1.76; low certainty). Furthermore, obesity was a significant risk factor for hospitalization (OR = 1.75, 95% CI 1.47-2.09; very low certainty), mechanical ventilation (OR = 2.24, 95% CI 1.70-2.94; low certainty), intensive care unit (ICU) admission (OR = 1.75, 95% CI 1.38-2.22; low certainty), and death (OR = 1.23, 95% CI 1.06-1.41; low certainty) in COVID-19 patients. In the subgroup analyses, these associations were supported by the majority of subgroups. Conclusion Obesity is associated with COVID-19, need for hospitalization, mechanical ventilation, ICU admission, and death due to COVID-19. Level of evidence Level I, systematic reviews and meta-analyses.

Antibody Response Induced by BNT162b2 and mRNA-1273 Vaccines against the SARS-CoV-2 in a Cohort of Healthcare Workers

“…According to our results and after controlling for potential confounders, clinical variables previously linked to poor prognoses regarding SARS-CoV-2 infection, such as age, BMI and arterial hypertension, were positively associated with increasing levels of anti-S protein antibody titer after vaccination [27][28][29][30][31], but exclusively in infected/Nprot+ subjects. Although previous work reported that smoking harbors protection against SARS-CoV-2 infection, we and others have found lower antibody levels after vaccination associated with this habit [7,31,32].…”

“…However, none of these works evaluated this vaccine's response in subjects previously infected by SARS-CoV-2 who had lost their response against the nucleocapsid protein (N protein) and, with it, a substantial part of the protection conferred by the infection. Other works reported the influence on the vaccine of different factors previously associated with the severity of the infection, namely, sex, age, obesity, arterial hypertension and smoking habit, providing results that show some inconsistencies across these studies [26][27][28][29][30][31][32][33][34][35]. Importantly, the time elapsed from vaccination and/or from infection to serology have a huge impact on the measurement of the antibody titer, but these data were not always controlled in the previous works.…”

Daily Physical Activity and Sleep Measured by Wearable Activity Trackers during the Coronavirus Disease 2019 Pandemic: A Lesson for Preventing Physical Inactivity during Future Pandemics

“…Apart from the effectiveness of lockdown for infection control during the pandemic, young people with obesity should be monitored carefully to prevent health problems due to physical inactivity when implementing lockdown and social distancing. Importantly, obesity is significantly associated with the increased risk of susceptibility to COVID-19 (odds ratio (OR), 2.42; 95% CI, 1.58-3.70), severity of COVID-19 (OR, 1.62; 95% CI, 1.48-1.76), hospitalization (OR, 1.75; 95% CI, 1.47-2.09), and death (OR, 1.23; 95% CI, 1.06-1.41) [21].…”

Body weight, vitamin D and zinc: A review of associations with coronavirus disease (COVID-19)

“…BMI has been established as a risk factor for adverse COVID outcomes, including increased risk for hospitalization [63], ICU admission [64], mechanical ventilation [65] and death [66].…”