Table 1.
The prevalence and prognosis of COVID-19 with obesity.
| First author (year) | Study design | Subject | Number of participants | Country | Age | Males (%) | Prevalence of COVID-19 with obesity | Prognosis of COVID-19 with obesity | Complications of COVID-19 |
|---|---|---|---|---|---|---|---|---|---|
| Anderson (2020)107 | Cross-sectional study | Hospitalized | 2673 | USA | 67 (median) | 58 | NA | Obesity was association with higher risk for adverse outcome (intubation or death) among patients younger than 65 years. | Comorbidities: hypertension (50%) and diabetes (19%) |
| Biscarini (2020)108 | Cohort study | Hospitalized | 331 | Italy | 67 (mean) | 68.2 | 24% | The association between obesity and the ICU admission of COVID-19 was statistically significant (OR = 1.96, 95% CI 1.03–3.75). | Comorbidities: hypertension (52%) and diabetes (40%) |
| Deng (2020)109 | Cohort study | Hospitalized | 65 | China | NA | NA | NA | The severe/critical cases of BMI ≥28 kg/m2 patients were more than BMI ≤ 24 kg/m2 patients (p < 0.001). | NA |
| Docherty (2020)48 | Cohort study | Hospitalized | 20,133 | UK | 72.9 (median) | 59.9 | 10.5% (1685/16081) | The association between obesity and the death of COVID-19 was statistically significant (OR = 1.33, 95% CI 1.19–1.49 (p < 0.001)). | Comorbidities: diabetes without complications (33.7%) and chronic cardiac disease (30.9%) The association between chronic cardiac disease and the death of COVID-19 was statistically significant (OR = 1.16, 95%CI 1.08–1.24 (p < 0.001)). |
| Dreher (2020)51 | Cohort study | Hospitalized | 50 | Germany | 65 (median) | 66 | 34% | COVID-19 with obesity patients had a higher incidence of ARDS than non-obesity patients (46%/23%). | Comorbidities: hypertension (70%), pre-existing respiratory disease (50%) and diabetes (58%) |
| Gao (2020)27 | Cohort study | Hospitalized | 150 | China | 48 (median) | 62.7 | 50% (randomized trial, obesity/non-obesity = 1:1) | COVID-19 with obesity patients were more severe than non-obesity patients (33.3%/14.7%, p = 0.007). COVID-19 with obesity patients had a longer hospital stays than non-obesity patients (median 23 (IQR 17–30)/18 (13–24) days, p = 0.037). |
Comorbidities: diabetes (19.3%) |
| Giacomelli (2020)47 | Cohort study | Hospitalized | 233 | Italy | 61 (median) | 69.1 | NA | The association between obesity and the death of COVID-19 was statistically significant (aHR = 3.04, 95% CI 1.42–6.49). | NA |
| Gupta (2020)110 | Cohort study | Hospitalized | 2215 | USA | 60.5 (mean) | 64.8 | NA | The ICU admission of BMI >40 kg/m2 patients were higher than BMI >25 kg/m2 patients (OR = 1.51, 95% CI: 1.01–2.25). | NA |
| Hu (2020)31 | Cohort study | Hospitalized | 323 | China | 61 (median) | 51.4 | 4% | The proportion of BMI >25 kg/m2 in critical group was higher than that in general group (23.1%/20.7%). | NA |
| Jakob (2020)111 | Cohort study | Hospitalized | 2155 | European (112 countries) | NA | 59.7 | NA | The complicated clinical stage of BMI >35 kg/m2 patients were higher than 18.5 < BMI <24.9 kg/m2 patients (OR = 2.21, 95% CI: 1.43–3.43). | Comorbidities: diabetes mellitus (18.4%) and CVD (55.7%). The association between diabetes mellitus and the complicated clinical stage of COVID-19 was statistically significant (aOR = 1.33, 95% CI 1.04–1.69). The association between CVD and the complicated clinical stage of COVID-19 was statistically significant (aOR = 1.37, 95% CI 1.09–1.72). |
| Nakeshbandi (2020)112 | Cohort stud | Hospitalized | 504 | USA | 68 (median) | 52 | 43% | Overweight (RR = 1.4, 95% CI 1.1–1.9) and obesity (RR = 1.3, 95% CI 1.0–1.7) was significantly increased risk of mortality of COVID-19. Overweight (RR = 2.0, 95% CI 1.2–3.3) and obesity (RR = 2.4, 95% CI 1.5–4.0) was significantly increased risk of intubation of COVID-19. |
Comorbidities: diabetes (53%) and hypertension (83%) |
| Nguyen (2020)113 | Cohort study | Hospitalized | 279 | France | 64.8 (mean) | 65.6 | 20.4% | The risk of IMV needing and death of BMI ≥25 kg/m2 patients were higher than BMI <25 kg/m2 patients (aHR = 2.14, 95% CI: 1.32–3.47 (p = 0.002)). | Comorbidities: diabetes (27.6%), hypertension (47.0%) and coronary heart disease (10.8%) |
| Ortiz-Brizuela (2020)29 | Cohort study | Diagnosed | 309 | Mexico | 43 (median) | 59.2 | 39.6% | ICU patients had a higher BMI than non-ICU patients (BMI, median 30.5 vs 28.77). | NA |
| Pettit (2020)114 | Cohort study | Hospitalized | 238 | USA | 58.5 (mean) | 37.5 | 61.3% | The mortality of COVID-19 patients in obesity group was higher than that in non-obesity group (OR = 1.7, 95% CI 1.1–2.8 (p = 0.016)). | Comorbidities: diabetes (28.6%) and hypertension (52.9%) |
| Rottoli (2020)115 | Cohort study | Hospitalized | 482 | Italy | NA | NA | 21.6% | The risk of respiratory failure (OR = 2.32, 95% CI: 1.31–4.09 (p = 0.004)) and ICU admission (OR = 4.96, 95% CI: 2.53–9.74 (p < 0.001)) of 30 ≤ BMI <35 kg/m2 patients were higher than BMI <30 kg/m2 patients. The risk of death of BMI ≥ 35 kg/m2 patients were higher than BMI <30 kg/m2 patients (OR = 12.1, 95% CI: 3.25–45.1 (p < 0.001)). |
NA |
| Simonnet (2020)43 | Cohort study | Hospitalized | 124 | France | 60 (median) | 73 | 47.5% | The IMV needing of BMI >35 kg/m2 patients were higher than BMI >25 kg/m2 patients (OR = 7.36, 95% CI: 1.63–33.14 (p = 0.02)). IMV requirement increased with BMI (p < 0.01, chi-square test). |
Comorbidities: diabetes (23%), hypertension (49%), dyslipidemia (28%) |
| Tartof (2020)116 | Cohort study | Diagnosed | 6916 | USA | 49.1(mean) | 45.0 | NA | The risk of death of BMI ≥ 45 kg/m2 patients were higher than normal BMI (18.5–24 kg/m2) patients (OR = 4.18, 95% CI: 3.25–45.1 (p < 0.001)). | NA |
| Yanover (2020)117 | Cohort study | Hospitalized | 4353 | Israel | NA | 55.5 | 20.1% | Obesity for patients younger than 65 years was significantly association with higher risk for severe symptoms (OR = 3.4, 95% CI: 1.88–6.14 (p = 0.001)). | Diabetes (OR = 3.16, 95% CI: 1.32–6.79 (p = 0.04)), CVD (OR = 2.76, 95% CI: 1.88–6.14 (p = 0.001)) and hypertension (OR = 4.56, 95% CI: 1.29–5.85 (p = 0.045)) for patients 18–50 years old was significantly association with higher risk for severe symptoms. |
| Alkhatib (2020)118 | Cross-sectional study | Hospitalized | 158 | USA | 57 (mean) | 38.6 | NA | Patients admitted to the ICU had higher BMI (26.5 kg/m2/31.9 kg/m2, p = 0.002). | Comorbidities: diabetes mellitus (48.1%), hypertension (67.7%) |
| Bello-Chavolla (2020)119 | Cross-sectional study | Diagnosed | 51,633 | Mexico | 46.5 (mean) | 57.7 | 20.7% | The association between obesity and the risk of death in COVID-19 patients was statistically significant (HR = 1.25, 95% CI 1.17–1.34, (p < 0.001)). | Comorbidities: diabetes (18.3%), hypertension (21.6%) The association between diabetes and the risk of death in COVID-19 patients was statistically significant (HR = 1.34, 95% CI 1.26–1.43, (p < 0.001)). |
| Busetto (2020)64 | Cross-sectional study | Hospitalized | 92 | Italy | NA | 61.9 | 65.2% | The IMV needing of overweight (16.1%) or obesity (6.9) patients were higher than normal weight (6.2%) patients. The assisted ventilation (NIV and IMV) needing of overweight (54.8%) or obesity (41.4%) patients were higher than normal weight (15.6%) patients. |
Comorbidities: hypertension (64.1%), CVD (31.5%), diabetes (30.4%) and respiratory chronic disease (13.0%) |
| Cai (2020)55 | Cross-sectional study | Hospitalized | 96 | China | NA | NA | NA | BMI was higher in COVID-19 patients with pneumonia than in those without pneumonia (23.81 kg/m2/20.78 kg/m2, p = 0.001). | NA |
| Cai (2020)120 | Cross-sectional study | Hospitalized | 383 | China | NA | 47.8 | 10.7% | Severe cases in normal weight group/overweight group/obesity group: 19.2%/29.3%/39.0% (p = 0.001). | Comorbidities: diabetes (5.7%), hypertension (15.1%) and CVD (9.1%) The proportion of hypertension in severe group was higher than that in non-severe group (23.08%/12.67% (p = 0.02)). The proportion of CVD in severe group was higher than that in non-severe group (18.68%/6.16% (p = 0.001)). |
| Cariou (2020)121 | Cross-sectional study | Hospitalized and diabetic | 1317 | France | 69.8 (mean) | 64.9 | 38.3% | The association between BMI and the primary outcome (tracheal intubation and/or death within 7 days of admission) was statistically significant (p < 0.001). | Comorbidities: hypertension (77.2%) The association between hypertension and death of COVID-19 was statistically significant (OR = 1.82, 95% CI: 1.11–2.98). |
| Caussy (2020)18 | Cross-sectional study | Hospitalized and severe | 340 | Italy | NA | NA | 25% | The proportion of obesity in severe COVID-19 patients was higher than that in general French adult population (OR = 1.35, 95% CI: 1.08–1.66). The proportion of obesity in critical COVID-19 patients was higher than that in ICU non-COVID-19 patients (OR = 1.69, 95% CI: 1.10–2.56). |
NA |
| Chand (2020)122 | Cross-sectional study | ICU patients | 300 | USA | 57.8 (mean) | 60.7 | NA | The association between BMI and the risk of relative mortality in COVID-19 patients was statistically significant (aOR = 1.02, 95% CI 1.01–1.04, (p = 0.004)). | NA |
| Chen (2020)123 | Cross-sectional study | Hospitalized | 145 | China | 47 (mean) | 54.5 | NA | The proportion of obesity in severe COVID-19 patients was higher than that in non-severe COVID-19 patients (24.78 kg/m2/23.20 kg/m2, p = 0.02). | Comorbidities: diabetes (9.7%) and hypertension (15.2%) |
| Denova-Gutierrez (2020)65 | Cross-sectional study | Hospitalized | 3844 | Mexico | 45.4 (mean) | 58.0 | 17.4% | The IMV needing (p < 0.001) and ICU care needing (p < 0.001) of obese group were higher than that in non-obese group. The proportion of severe cases in obese group was higher than that in non-obese group (22.9%/15.1%, p < 0.01). |
Comorbidities: diabetes (17.4%), hypertension (14.5%) and CVD (18.9%) |
| Ebinger (2020)124 | Cross-sectional study | Diagnosed | 442 | USA | 52.72 (mean) | 57.9 | 16.1% | COVID-19 with obesity patients required a higher level of care than non-obesity patients (OR = 1.95, 95% CI 1.11–3.42, p = 0.021). | Comorbidities: diabetes mellitus (19.0%) and hypertension (36.4%) COVID-19 patients with diabetes mellitus required a higher level of care than non-diabetic patients (OR = 1.77, 95% CI 1.03–3.03, p = 0.037). |
| Fried (2020)66 | Cross-sectional study | Hospitalized | 11,721 | USA | NA | 53.4 | 16.1% | The association between obesity and the risk of IMV in COVID-19 patients was statistically significant (p = 0.0042). | Comorbidities: diabetes (27.8%) and CVD (18.6%) The association between diabetes (p < 0.0001) or CVD (p < 0.0001) and the risk of IMV in COVID-19 patients was statistically significant. |
| Gayam (2020)125 | Cross-sectional study | Diagnosed | 408 | USA | 47 (median) | 56.62 | NA | BMI in non-survivors COVID-19 patients was significantly higher than that in survivors COVID-19 patients (31.8 kg/m2/28.3 kg/m2, p = 0.002). | Comorbidities: diabetes (43.24%) and hypertension (66.42%) |
| Giannouchos (2020)126 | Cross-sectional study | Diagnosed | 89,756 | Mexico | 46.2 (median) | 56.4 | 20.5% | The proportion of obesity in hospitalized COVID-19 patients was higher than that in non-hospitalized patients (24.1%/18.6% (p < 0.001)). The proportion of obesity in adverse outcome COVID-19 patients was higher than that in non-adverse outcome patients (27.0%/19.5% (p < 0.001)). |
Comorbidities: diabetes (17.5%) and hypertension (20.9%) |
| Goyal (2020)45 | Cross-sectional study | Hospitalized | 393 | USA | 62.2 (median) | 60.6 | 35.8% | The proportion of obesity in IMV COVID-19 patients was higher than that in non-IMV COVID-19 patients (IMV/non-IMV = 43.4%/31.9%). | Comorbidities: diabetes (25.2%) and hypertension (50.1%) |
| Hajifathalian (2020)30 | Cross-sectional study | Hospitalized | 770 | USA | 63.5 (mean) | 61 | NA | COVID-19 with obesity patients had a higher rate of ICU admission (p = 0.001). COVID-19 with obesity patients had a higher rate of intubation (p < 0.001). COVID-19 with obesity patients had a higher rate of ICU admission or death (RR = 1.58, p = 0.002). |
NA |
| Hernández-Galdamez (2020)54 | Cross-sectional study | Diagnosed | 212,802 | Mexico | 45.7 (mean) | 54.71 | 19.51% | The association between obesity and the risk of ICU admission (aOR = 1.59, 95% CI 1.49–1.69, (p < 0.001)), hospitalization (aOR = 1.29, 95% CI 1.25–1.32, (p < 0.001)), endotracheal intubation (aOR = 1.62, 95% CI 1.53–1.71, (p < 0.001)) and death (aOR = 1.42, 95% CI 1.37–1.47, (p < 0.001)) in COVID-19 patients was statistically significant. | Comorbidities: hypertension (20.12%) and diabetes (16.44%) The association between diabetes or hypertension and the risk of ICU admission, hospitalization, endotracheal intubation and death in COVID-19 patients was statistically significant (p < 0.001). |
| Hu (2020)127 | Cross-sectional study | Hospitalized | 58 | China | 49.2 (mean) | 62.1 | NA | The hospital stays of BMI ≥24 kg/m2 COVID-19 patients were longer than BMI <24 kg/m2 COVID-19 patients (20.4 ± 4.4/17.4 ± 6.1 (p = 0.046)). | NA |
| Huang (2020)36 | Cross-sectional study | Hospitalized | 202 | China | 44 (median) | 57.4 | 14% | COVID-19 with obesity patients were more severe than non-obesity patients (OR = 9.219, 95% CI 2.731–31.126 (p < 0.001)). | Comorbidities: hypertension (14.4%) and diabetes (9.4%) COVID-19 with diabetes patients were more severe than non-pre-existing CVD patients (OR = 4.326, 95%CI 1.059–17.668 (p = 0.041)). ICU admission of COVID-19 patients with complication: 5.4% |
| Hur (2020)128 | Cross-sectional study | Hospitalized | 486 | USA | 58 (median) | 55.8 | 53.3% | The extubation chance of BMI <30 kg/m2 intubated patients were higher than 30 < BMI <39.9 kg/m2 patients (OR = 0.53, 95% CI: 0.32–0.90) or BMI ≥40 kg/m2 patients (OR = 0.40, 95% CI: 0.19–0.82). | NA |
| Kalligeros (2020)34 | Cross-sectional study | Hospitalized | 103 | USA | 60 (median) | 61.1 | 47.5% | COVID-19 with obesity patients had a higher IMV needing than non-obesity patients (OR = 2.6, 95% CI: 1.05–44.82). | Comorbidities: hypertension (64.0%), heart disease (24.2%), and diabetes (36.8%) ICU admission of COVID-19 patients with complication: 39.8% |
| Kass (2020)19 | Cross-sectional study | Hospitalized | 265 | USA | NA | 58 | NA | The negative association between BMI and age was significant (r2 = 0.051, p = 0.0002). | NA |
| Kim (2020)129 | Cross-sectional study | Hospitalized | 2491 | USA | 62 (median) | 53.2 | 49.7% | The association between obesity and the risk of ICU admission in COVID-19 patients was statistically significant (aRR = 1.31, 95% CI 1.16–1.47). | Comorbidities: hypertension (57.4%), CVD (34.6%) and diabetes (32.9%) The association between diabetes and the risk of ICU admission in COVID-19 patients was statistically significant (aRR = 1.13, 95% CI 1.03–1.24). |
| Klang (2020)130 | Cross-sectional study | Hospitalized | 3406 | USA | NA | 57.6 | 36.1% | At age < 50, BMI >40 was independently associated with mortality (OR = 5.1, 95% CI 2.3–11.1). At age > 50, BMI >40 was independently associated with mortality (OR = 1.6, 95% CI 1.2–2.3). |
NA |
| Ko (2020)20 | Cross-sectional study | Hospitalized | 5416 | USA | NA | NA | 55% | The association between obesity (aRR = 2.9, 95% CI 2.3–3.5) or severe obesity (aRR = 4.4, 95% CI 3.4–5.7) and the risk of COVID-19-associated hospitalization was statistically significant. | Comorbidities: hypertension (49%) and diabetes (33%) The association between hypertension (aRR = 3.6, 95% CI 2.3–5.8) or diabetes (aRR = 3.2, 95% CI 2.5–4.1) and the risk of COVID-19-associated hospitalization was statistically significant |
| Lighter (2020)33 | Cross-sectional study | Hospitalized | 3615 | USA | NA | NA | 37.9% | At age < 60, the critical care needing of BMI ≥30 kg/m2 patients were higher than BMI <30 kg/m2 patients (OR = 1.8, 95% CI: 1.2–2.7 (p = 0.006)). At age < 60, the critical care needing of BMI >35 kg/m2 patients were higher than BMI <30 kg/m2 patients (OR = 3.6, 95% CI: 2.5–5.3 (p < 0.0001)). |
NA |
| Imam (2020)50 | Cross-sectional study | Diagnosed | 2040 | USA | NA | NA | NA | The association between obesity and the risk of hospitalization in COVID-19 patients was statistically significant (aOR = 1.8, 95% CI 1.4–2.4, (p < 0.0005)). | NA |
| Moriconi (2020)28 | Cross-sectional study | Hospitalized | 100 | Italy | NA | 52 | 29% | COVID-19 with obesity patients had a longer hospital stays than non-obesity patients (21 ± 8/13 ± 8 days, p = 0.0008). | Comorbidities: hypertension (55%), chronic heart failure (28%) and diabetes (25%) |
| Mughal (2020)131 | Cross-sectional study | Hospitalized | 129 | USA | 63.0 (median) | 62.8 | 14% | The proportion of obesity in IMV COVID-19 patients was higher than that in non-IMV COVID-19 patients (IMV/non-IMV = 26.7%/10.1% (p = 0.0334)). | Comorbidities: hypertension (43.4%) and diabetes mellitus (19.4%) The proportion of diabetes mellitus in IMV COVID-19 patients was higher than that in non-IMV COVID-19 patients (IMV/non-IMV = 36.7%/14.1% (p = 0.0063)). |
| Muñoz-Price (2020)67 | Cross-sectional study | Hospitalized | 2595 | USA | 53.8 (mean) | 37.7 | NA | The association between BMI and the risk of IMV (OR = 1.06, 95% CI 1.02–1.09, (p = 0.003)) and in-hospital death (OR = 1.19, 95% CI 1.05–1.35, (p = 0.006)) in COVID-19 patients was statistically significant. | NA |
| Onder (2020)132 | Cross-sectional study | dead | 3694 | Italy | NA | NA | NA | The association between obesity and the risk of acute renal failure (OR = 1.33, 95% CI 1.04–1.71, (p < 0.001)) and shock (OR = 1.54, 95% CI 1.19–1.99, (p < 0.001)) in COVID-19 patients was statistically significant. | NA |
| Ong (2020)44 | Cross-sectional study | Hospitalized | 182 | Singapore | NA | NA | NA | At age < 60, the IMV needing of BMI ≥25 kg/m2 patients were higher than BMI <25 kg/m2 patients (OR = 1.16, 95% CI: 1.00–1.34 (p = 0.049)). | NA |
| Palaiodimos (2020)46 | Cross-sectional study | Hospitalized | 200 | USA | 64 (median) | 49 | NA | The mortality of COVID-19 patients varied significantly among BMI <25 kg/m2 group, BMI 25–34 kg/m2 group, BMI ≥35 kg/m2 group (31.6%/17.2%/34.8%, p = 0.030). The intubation of COVID-19 patients varied significantly among BMI <25 kg/m2 group, BMI 25–34 kg/m2 group, BMI ≥35 kg/m2 group (18.4%/16.4%/34.8%, p = 0.032). |
Comorbidities: hypertension (76%), hyperlipidemia (46.2%), and diabetes (39.5%) |
| Peters (2020)133 | Cross-sectional study | Dead | 410 | UK | NA | 64% | NA | Both men (aHR = 1.78, 95% CI 1.44–2.21) and women (aHR = 2.21, 95% CI 1.69–2.88) with a higher BMI had a higher risk of death than those with a healthy weight. | NA |
| Rapp (2020)134 | Cross-sectional study | Hospitalized | 4062 | USA | NA | 57.4 | NA | The association between BMI ≥35 kg/m2 and the risk of death in COVID-19 patients was statistically significant (aOR = 1.53, 95% CI 1.21–1.94). | NA |
| Seiglie (2020)135 | Cross-sectional study | Hospitalized | 450 | USA | NA | NA | NA | The association between obesity and the risk of IMV (OR = 2.13, 95% CI 1.14–4.00) and ICU admission (OR = 2.16, 95% CI 1.20–3.88) in COVID-19 patients was statistically significant. | Comorbidities: diabetes (39.6%) The association between diabetes and the risk of IMV (OR = 1.97, 95% CI 1.21–3.20), death (OR = 2.13, 95% CI 1.14–4.00) and ICU admission (OR = 1.59, 95% CI 1.01–2.52) in COVID-19 patients was statistically significant. |
| Shah (2020)136 | Cross-sectional study | Hospitalized | 552 | USA | 63 (median) | 42 | 66.5% | The association between morbid obesity and in-hospital mortality in COVID-19 patients was statistically significant (OR = 2.29, 95% CI 1.11–4.69 (p = 0.02)). | Comorbidities: hypertension (79.7%) and diabetes mellitus (42.3%) The association between hypertension and in-hospital mortality in COVID-19 patients was statistically significant (OR = 3.36, 95% CI 1.3–8.6 (p = 0.01)). |
| Soares (2020)52 | Cross-sectional study | Diagnosed | 24,428 | Brazil | NA | NA | NA | The association between obesity and the risk of hospitalization in COVID-19 patients was statistically significant (aOR = 1.74, 95% CI 1.35–2.23 (p < 0.001)). | The association between diabetes (aOR = 1.34, 95% CI 1.10–1.61 (p = 0.003)) or CVD (aOR = 1.30, 95% CI 1.11–1.53 (p = 0.001)) and the risk of hospitalization in COVID-19 patients was statistically significant. |
| Sterling (2020)137 | Cross-sectional study | Hospitalized | 256 | USA | NA | NA | NA | The association between obesity and the risk of IMV in COVID-19 patients was statistically significant (aOR = 4.5, 95% CI 1.98–10.27 (p = 0.0003)). | The association between history of diabetes mellitus and the risk of IMV in COVID-19 patients was statistically significant (aOR = 2.55, 95% CI 1.13–5.75 (p = 0.023)). |
| Suleyman (2020)138 | Cross-sectional study | Diagnosed | 463 | USA | 57.5 (mean) | 44.1 | 57.2% | The association between severe obesity and the risk of IMV in COVID-19 patients was statistically significant (aOR = 3.2, 95% CI 1.7–6.0 (p < 0.001)). | Comorbidities: hypertension (68.7%) and diabetes (38.8%) |
| Targher (2020)139 | Cross-sectional study | Hospitalized | 339 | China | NA | NA | 38.4% | COVID-19 with obesity patients had a higher risk for severe COVID-19 illness (OR = 2.51, 95% CI 1.3–4.7). | NA |
| Wang (2020)56 | Cross-sectional study | Hospitalized | 297 | China | 38.00 (mean) | 55.22 | 13.47% | Overweight (OR = 5.000, 95% CI 1.611–15.516 (p = 0.005)) and obesity (OR = 11.333, 95% CI 3.329–38.583 (p < 0.001)) was significantly associated with severe illness of COVID-19. The proportion of COVID-19 patients developing ARDS was higher in patients with obesity than lean patients (5.00%/0%, p = 0.024). |
Type 2 diabetes was significantly associated with severe illness of COVID-19 (OR = 5.333, 95% CI 1.800–15.800 (p = 0.003)). |
| Xie (2020)140 | Cross-sectional study | Hospitalized | 267 | USA | 61.5 (mean) | 43.2 | NA | The association between obesity and the risk of IMV (aOR = 2.36, 95% CI 1.33–3.20), ARDS (aOR = 2.44, 95% CI 1.28–4.65) and ICU admission (aOR = 2.18, 95% CI 1.25–3.81) in COVID-19 patients was statistically significant. | The association between diabetes and the risk of IMV (aOR = 2.12, 95% CI 1.16–3.89) and ICU admission (aOR = 2.22, 95% CI 1.24–3.98) in COVID-19 patients was statistically significant. |
| Yu (2020)53 | Cross-sectional study | Hospitalized | 95 | China | NA | NA | NA | The association between high BMI and the risk of pneumonia in COVID-19 patients was statistically significant (OR = 1.327, p = 0.024). | NA |
| Zheng (2020)141 | Cross-sectional study | Hospitalized and MAFLD | 66 | China | 47.0 (median) | 74.2 | 68.2% | COVID-19 with obesity patients were more severe than non-obesity patients (OR = 6.32, 95% CI: 1.16–34.54 (p = 0.033)). | NA |
ARDS – acute respiratory distress syndrome; BMI – body mass index; CI – confidence interval; CVD – cardiovascular disease; GPU – general practice unit; ICU – intensive care unit; NIV – non-invasive mechanical ventilation; IMV – invasive mechanical ventilation; aHR – adjusted hazard ratio; aOR – adjusted odds ratio; NA – not available; NAFLD – nonalcoholic fatty liver disease; OR – odds ratio; RR – relative ratio.