Does higher BMI increase COVID-19 severity?: a systematic review and meta-analysis

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Abstract

Introduction

COVID-19 pandemic has caused havoc worldwide, and different comorbidities have been seen to exacerbate the condition. Obesity is one of the leading comorbidities, which is associated with many other diseases. In this paper, we present a systematic review and meta-analysis estimating the effects of overweight and obesity on COVID-19 disease severity.

Methodology

Two electronic databases (Medline and Cochrane library) and one grey literature database (Grey Literature Report) were searched using the following keywords: overweight, obesity, body mass index, respiratory disease, coronavirus, COVID-19. The risks of bias of the selected studies were assessed by using the Navigation Guide method for human data. Both random and fixed effect meta-analysis were determined using Review Manager (RevMan) software version 5.4.

Results

After initial screening, 12 studies (7 cohort studies, four case-control studies, and one cross-sectional study) were fulfilled the eligibility criteria, comprising a total of 405359 patients and included in the systematic review. The pooled risk of disease severity was 1.31 times higher based on both fixed and random effect model among those overweight patients,I20% and 2.09 and 2.41 times higher based on fixed and random effect respectively among obese patients,I242% compared to healthy individuals.

Conclusion

Overweight and obesity are common risk factors for disease severity of COVID-19 patients. However, further assessment of metabolic parameters included BMI, waist-hip ratio, and insulin levels, are required to estimate the risk factors of COVID-19 patients and understanding the mechanism between COVID-19 and body mass index.

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