Introduction
Methods
Search Strategy and Selection of Studies
Selection of Studies: Inclusion and Exclusion Criteria
Data Extraction and Quality Assessment
Title | Authors | Study design | Selection | Comparability | Exposure | Quality |
---|---|---|---|---|---|---|
Obesity and COVID-19 severity in a designated hospital in Shenzhen, China | Cai et al. | Retrospective study | ●●● | ● | ●● | Good |
COVID-19 and the role of chronic inflammation in patients with obesity | Chiappetta et al. | Retrospective study | ●● | ● | ● | Poor |
Characteristics of emergency department patients with COVID-19 at a single site in Northern California: clinical observations and public health implications | Duanmu et al. | Cross-sectional study | ●● | ● | ●● | Good |
Obesity is a risk factor for greater COVID-19 severity | Goa et al. | Case-control study | ●● | ● | ●● | Good |
Association of Obesity with Disease Severity among patients with COVID-19 | Kalligeros et al. | Retrospective cohort study | ●● | ● | ●●● | Good |
OpenSAFELY: factors associated with COVID-19 related hospital death in the linked electronic health records of 17 million adult NHS patients | Goldacre et al. | Retrospective cohort study | ●●●● | ●● | ●●● | Good |
High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2) requiring invasive mechanical ventilation | Simonnet et al. | Retrospective cohort study | ●● | ● | ●●● | Good |
Clinical and chest radiography features determine patient outcomes in young and middle age adults with COVID-19 | Toussie et al. | Retrospective study | ●● | ●● | ●● | Good |
Clinical characteristics of 145 patients with corona virus disease 2019 (COVID-19) in Taizhou, Zhejiang, China | Chen et al. | Retrospective study | ●● | ● | ●● | |
Bariatric surgical practice during the initial phase of COVID-19 outbreak | Aminian et al. | Retrospective cohort study | ●● | ● | ●●● | Good |
Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a long study | Pietrobelli et al. | Longitudinal cohort study | ●● | ● | ●● |
Results
Study Characteristics (Table 2)
Authors | Sample size | Age | Gender (male N (%)) | BMI definition | BMI of sample population | Comorbidities | Mortality | Hospital admission | Duration of hospital stay | ICU admission | Use of ventilator |
---|---|---|---|---|---|---|---|---|---|---|---|
Toussie et al | 338 | Median age 39 (31–45) | 210 (62%) | BMI > 30 | 130 (40%) obese or morbidly obese | Hypertension 54 (16%), asthma 46 (14%), and diabetes mellitus type II 39 (12%) | 10 (7%) of admitted | 145/338 admitted | 29 (20%) had stay > 10 days | NA | 28 (19%) |
Duanmu et al | 100 | Median 15 (32–65) | 56 (56%) | BMI > = 30 | 22% obese | Hypertension 19 (19%), diabetes 10%, CKD 6%, immunosuppressive meds 4%, cancer 3%, hyperlipidemia 14%, asthma 10%, COPD 1% | 1% | 24 | Median 9 days | 6% | 4% |
Richarson et al | 5700 | Median 63 | 60.30% | BMI > =30 obese, morbidly obese BMI > =35 | 1737 (41.7%) obese, 791 (19.0%) morbidly obese | Hypertension (3026;56.6%), diabetes (1808; 33.8%), CVD, cancer, chronic respiratory disease, immunosuppression, (HIV, hx organ transplant), kidney disease, liver disease | 553 (21%) | All 5700 | 4.1 days (IQ. 2.3–6.8) | 373 (14.2%) | 320 (12.2%) |
Kalligeros et al | 103 | Median 60 (52–70) | 63 (61.17%) | BMI > =35 severely obese, BMI > =30 obese | 49/103 (47.5%) obese | HTN (64%), diabetes (36.8%) and heart disease (24.2%) | NA | All 103 | NA | 41 (39.8%) | 29 (28.2%) |
Simonnet et al | 124 | Median 60 9IQR 51–70) | 73% | BMI > 30 kg/m2 obese, MBMI > 35 kg/m2 severe obesity | Obesity in 47.6% and severe obesity in 28.2% | Diabetes 23%, hypertension 49%, dyslipidemia 28% | 15% | All 124 in ICU | NA | 124 | 85 (69%) |
Gao et al | 150 | Mean age 48 years | 62.70% | BMI > =25 kg/m2 obese | Obese mean BMI: 27.7; non-obese mean BMI 21.8 | Diabetes (19.3%), hypertension, dyslipidemia | NA | NA | Obese (median days): 23, non-obese. 18 | NA | NA |
Huang et al | 221 | Median 45.0 (IQR. 33.5–56.0) | 57% | BMI > =28 obese | Median 24.4 | Sixty (27.1%) patients but at least one underlying disease including hypertension (21 [14.5%]), type 2 diabetes (21 [9.5%]), chronic lung diseases (7 [3.2%]), chronic liver diseases (6 [2.7%]), cardiovascular diseases (5 [2.3%]) cerebrovascular diseases (3 [1.4%]), and malignant tumors (3 [1.4%]) | 0 | NA (all hospitalized) | NA | 11 (5.0%) | 4.10% |
Goldacre et al | 17 m | 18 < 40 34.4%;40– < 50 16.5%;50 < 60 17.6%;60 < 70 13.8%;70– < 80:11.2%; 80 + 6.5% | 49.90% | BMI 30–34.9 Obese class I. BMI 35–39.9 obese class II. BMI > =40 obese class III | 13.8% BMI 30–34.9+ 5.3% BMI 35–39.9 2.7% BMI > =40 | HTN (53%), respiratory diseases 4.1% (chronic heart disease 6.7%, uncontrolled DM 2.8%, controlled DM 6.0%, cancer liver. disease, neurological disease, rheumatological disease, immunosuppressive condition | < 0.01% in 18–3 years, 0.35% and 0.17% in men and women aged > = 80 years. Total 5683 | NA | NA | NA | NA |
Cai et al | 383 | N:50 (36–62); U:35.5 (28–60); OW:50 (37–61); O:48 (39–54) | N:77 (37.8); U:2 (12.5); OW:73(59.4); O:32 (78.1) | BMI < 18.5 kg/m2 underweight, 18.5–23.9 kg/m2 normal weight, 24.0–27.9 kg/m2 overweight, and ≥ 28 kg/m2 obese | 53.1% normal weight (N), 4.2% underweight (U), 32.0% overweight (OW), and 10.7% obese (O) | Diabetes, hypertension, CVD, liver diseases, cancer | Did not specify | All 383 were hospitalized | Did not specify | N:16 (7.8%), U: 0; OW:14 (11.4%); O:5 (12.2%) | N:16 (7.8%); U:0; OW:14(11.4%); O: 5 (12.2%) |
Chiappetta et al | 33 | Median 44.51 ± 11.08 (24–61) | Did not specify | Did not define | EOSS 2–3, BMI: 61.94 ± 12.3 (35–83.2) | Did not specify | NA | NA | NA | NA | NA |
Chen et al | 145 | Mean 47.5 | 54.50% | Did not define | Non-severely ill, 23.20;severely ill, 24.78 | HTN (15.2%), DM (9.7%), COPD, chronic liver disease, chronic kidney, peptic ulcer, solid tumor, chronic cardiac insufficiency, HIV, hyperlipidemia | NA | All 145 | NA | 1 (0.7%) | 1 (0.7%) |