Increased COVID-19 Infection Susceptibility and Adverse Outcomes Due to Obesity: A Systematic Review and Meta-analysis (preprint)

ABSTRACT

Objectives: Study bidirectional relationships between weight gain, obesity and COVID-19 infection risk during the pandemic.Methods: MEDLINE, Embase, MedRxiv, and WHO COVID-19 Database were searched till June 2, 2020. Newspaper and internet article sources were identified using a media database. Meta-analysis was conducted using random- and fixed effect models.Results: Ten studies published from 5 countries met inclusion criteria; five studies (provided 17 analyses/types of results) were included in meta-analysis. The studies suggested bidirectional relationships and some dose-response relationships. Meta-analysis showed obesity was associated with increased COVID-19 infection risk (Odds ratio, OR=1.69, 95% CI 1.41, 2.02). COVID-19 risk increased with obesity (OR=1.43 (1.18, 1.73)) and severe obesity (OR=1.96 (1.49, 2.59)). Obesity was positively associated with COVID-19 mortality (OR=1.64, 95% CI 1.20, 2.25) and its severity admission to intensive care unit (ICU) (OR=2.01 (1.25, 3.23)), and invasive mechanical ventilation (IMV) use (OR=8.20 (2.10, 31.91)). We also observed a stronger association in younger age groups (β=-0.29 (-0.47 to -0.10)).Conclusions: Obesity was positively associated with higher COVID-19 infection risk, severity, and mortality. Appropriate treatment of COVID-19 patients with obesity and weight management are warranted.