The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis
Abstract Background Obesity accompanied by excess ectopic fat storage has been postulated as a risk factor for severe disease in people with SARS‐CoV‐2 through the stimulation of inflammation, functional immunologic deficit and a pro‐thrombotic disseminated intravascular coagulation with associated...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Endocrinology, Diabetes & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/edm2.176 |
| _version_ | 1819275835134181376 |
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| author | Samuel Seidu Clare Gillies Francesco Zaccardi Setor K. Kunutsor Jamie Hartmann‐Boyce Thomas Yates Awadhesh Kumar Singh Melanie J. Davies Kamlesh Khunti |
| author_facet | Samuel Seidu Clare Gillies Francesco Zaccardi Setor K. Kunutsor Jamie Hartmann‐Boyce Thomas Yates Awadhesh Kumar Singh Melanie J. Davies Kamlesh Khunti |
| author_sort | Samuel Seidu |
| collection | DOAJ |
| description | Abstract Background Obesity accompanied by excess ectopic fat storage has been postulated as a risk factor for severe disease in people with SARS‐CoV‐2 through the stimulation of inflammation, functional immunologic deficit and a pro‐thrombotic disseminated intravascular coagulation with associated high rates of venous thromboembolism. Methods Observational studies in COVID‐19 patients reporting data on raised body mass index at admission and associated clinical outcomes were identified from MEDLINE, Embase, Web of Science and the Cochrane Library up to 16 May 2020. Mean differences and relative risks (RR) with 95% confidence intervals (CIs) were aggregated using random effects models. Results Eight retrospective cohort studies and one cohort prospective cohort study with data on of 4,920 patients with COVID‐19 were eligible. Comparing BMI ≥ 25 vs <25 kg/m2, the RRs (95% CIs) of severe illness and mortality were 2.35 (1.43‐3.86) and 3.52 (1.32‐9.42), respectively. In a pooled analysis of three studies, the RR (95% CI) of severe illness comparing BMI > 35 vs <25 kg/m2 was 7.04 (2.72‐18.20). High levels of statistical heterogeneity were partly explained by age; BMI ≥ 25 kg/m2 was associated with an increased risk of severe illness in older age groups (≥60 years), whereas the association was weaker in younger age groups (<60 years). Conclusions Excess adiposity is a risk factor for severe disease and mortality in people with SARS‐CoV‐2 infection. This was particularly pronounced in people 60 and older. The increased risk of worse outcomes from SARS‐CoV‐2 infection in people with excess adiposity should be taken into account when considering individual and population risks and when deciding on which groups to target for public health messaging on prevention and detection measures. Systematic review registration: PROSPERO 2020: CRD42020179783. |
| first_indexed | 2024-12-23T23:30:38Z |
| format | Article |
| id | doaj.art-dcc052c7352d4398aabee0c65134c720 |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-12-23T23:30:38Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-dcc052c7352d4398aabee0c65134c7202022-12-21T17:26:03ZengWileyEndocrinology, Diabetes & Metabolism2398-92382021-01-0141n/an/a10.1002/edm2.176The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysisSamuel Seidu0Clare Gillies1Francesco Zaccardi2Setor K. Kunutsor3Jamie Hartmann‐Boyce4Thomas Yates5Awadhesh Kumar Singh6Melanie J. Davies7Kamlesh Khunti8Diabetes Research Centre Leicester General Hospital University of Leicester Leicester UKDiabetes Research Centre Leicester General Hospital University of Leicester Leicester UKDiabetes Research Centre Leicester General Hospital University of Leicester Leicester UKNational Institute for Health Research Bristol Biomedical Research Centre University Hospitals Bristol NHS Foundation Trust University of Bristol Bristol UKNuffield Department of Primary Care Health Sciences Centre for Evidence‐Based Medicine University of Oxford Oxford UKDiabetes Research Centre Leicester General Hospital University of Leicester Leicester UKDiabetes & Endocrinology G.D Hospital & Diabetes Institute Kolkata IndiaDiabetes Research Centre Leicester General Hospital University of Leicester Leicester UKDiabetes Research Centre Leicester General Hospital University of Leicester Leicester UKAbstract Background Obesity accompanied by excess ectopic fat storage has been postulated as a risk factor for severe disease in people with SARS‐CoV‐2 through the stimulation of inflammation, functional immunologic deficit and a pro‐thrombotic disseminated intravascular coagulation with associated high rates of venous thromboembolism. Methods Observational studies in COVID‐19 patients reporting data on raised body mass index at admission and associated clinical outcomes were identified from MEDLINE, Embase, Web of Science and the Cochrane Library up to 16 May 2020. Mean differences and relative risks (RR) with 95% confidence intervals (CIs) were aggregated using random effects models. Results Eight retrospective cohort studies and one cohort prospective cohort study with data on of 4,920 patients with COVID‐19 were eligible. Comparing BMI ≥ 25 vs <25 kg/m2, the RRs (95% CIs) of severe illness and mortality were 2.35 (1.43‐3.86) and 3.52 (1.32‐9.42), respectively. In a pooled analysis of three studies, the RR (95% CI) of severe illness comparing BMI > 35 vs <25 kg/m2 was 7.04 (2.72‐18.20). High levels of statistical heterogeneity were partly explained by age; BMI ≥ 25 kg/m2 was associated with an increased risk of severe illness in older age groups (≥60 years), whereas the association was weaker in younger age groups (<60 years). Conclusions Excess adiposity is a risk factor for severe disease and mortality in people with SARS‐CoV‐2 infection. This was particularly pronounced in people 60 and older. The increased risk of worse outcomes from SARS‐CoV‐2 infection in people with excess adiposity should be taken into account when considering individual and population risks and when deciding on which groups to target for public health messaging on prevention and detection measures. Systematic review registration: PROSPERO 2020: CRD42020179783.https://doi.org/10.1002/edm2.176mortalityobesitySARS‐CoV‐2severe disease |
| spellingShingle | Samuel Seidu Clare Gillies Francesco Zaccardi Setor K. Kunutsor Jamie Hartmann‐Boyce Thomas Yates Awadhesh Kumar Singh Melanie J. Davies Kamlesh Khunti The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis Endocrinology, Diabetes & Metabolism mortality obesity SARS‐CoV‐2 severe disease |
| title | The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis |
| title_full | The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis |
| title_fullStr | The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis |
| title_full_unstemmed | The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis |
| title_short | The impact of obesity on severe disease and mortality in people with SARS‐CoV‐2: A systematic review and meta‐analysis |
| title_sort | impact of obesity on severe disease and mortality in people with sars cov 2 a systematic review and meta analysis |
| topic | mortality obesity SARS‐CoV‐2 severe disease |
| url | https://doi.org/10.1002/edm2.176 |
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