Excess adiposity is a risk factor for severe disease and mortality in people with COVID-19 infection

Objectives:
Obesity accompanied by excess ectopic fat storage has been postulated as a risk factor for severe disease in people with SARS-CoV-2 (COVID-19) through the stimulation of inflammation, functional immunologic deficit and a pro-thrombotic disseminated intravascular coagulation with associated high rates of venous thromboembolism. Therefore, this review article has been conducted.

Is an increased BMI a risk factor for severe disease and death with COVID‐19?

Study design:
This review article included 8 retrospective cohort studies and 1 prospective cohort study with data on of 4,920 patients with COVID-19, of which 841 developed severe illness and 136 died.

The average age at baseline ranged from approximately 43 to 64 years, with a weighted mean (SD) of 56.8 (8.3) years.
All studies enrolled both male and female patients.
The overall NOS methodological quality scores of studies ranged from 4 to 7.

Results and conclusions:   
The investigators found comparing BMI ≥ 25 vs 25 kg/m², the RR of severe illness and mortality were 2.35 [95% CI = 1.43 to 3.86] and 3.52 [95% CI = 1.32 to 9.42], respectively.

The investigators found in a pooled analysis of 3 studies, the RR of severe illness comparing BMI > 35 vs 25 kg/m² was 7.04 [95% CI = 2.72 to 18.20].

The investigators found 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).

The investigators concluded despite important differences between studies and relatively small sample sizes, data consistently suggest excess adiposity is a risk factor for severe disease and mortality in people with SARS‐CoV‐2 (COVID-19) infection. This is particularly pronounced in older age groups and in higher BMI ranges. The increased risk of worse outcomes from SARS‐CoV‐2 (COVID‐19) infection in people with overweight and obesity should be taken into account when considering individual and population risks and when deciding on which groups to target with public health messaging and increased prevention and detection measures.

Original title:
The impact of obesity on severe disease and mortality in people with SARS-CoV-2: A systematic review and meta-analysis by Seidu S, Gillies C, […], Khunti K.

Link:
https://onlinelibrary.wiley.com/doi/full/10.1002/edm2.176

Additional information of El Mondo:
Find more information/studies on coronavirus right here.