Table 2.
Studies not supporting the theory of “obesity-paradox”.
| No. | Authors | Study Design No. of Participants Country |
Diagnosis of COVID-19 | Measure of Obesity | Outcomes | Results/Conclusions |
|---|---|---|---|---|---|---|
| 1. | Halasz et al. [40] | Retrospective cohort study (n = 242) in Italy | RT-PCR | Underweight (<18.5 kg/m2) Normal weight (18.5–25 kg/m2) Overweight (25–30 kg/m2) Obese class I (30–35 kg/m2) Obese class II (35–40 kg/m2) Obese class III (>40 kg/m2) |
Mortality | Severe obesity is associated with a greater mortality rate in individuals that were invasively ventilated, the study not being able to validate the theory of the obesity paradox. |
| 2. | Tartof et al. [41] | Retrospective cohort study (n = 6916) in California | RT-PCR | Underweight (less than 18.5 kg/m2) Normal (18.5 to 24 kg/m2) Overweight (25 to 29 kg/m2) Obese class I (30 to 34 kg/m2) Obese class II (35 to 39 kg/m2) Obese class III or extreme obesity (>40 kg/m2) |
In-hospital morality | There is a relationship between BMI and death, as BMI increases, the risk for death also increases, with more than 4 times for the highest BMI. |
| 3. | Bello-Chavolla et al. [42] | Retrospective study (n = 51,633) in Mexico | RT-PCR | N/A | In-hospital morality | Obesity increases the risk of bad outcomes in COVID-19 disease, including mortality. |
| 4. | Arjun et al. [43] | Retrospective study (n = 142) in USA | RT-PCR | Nonobese (BMI < 30 kg/m2) Obese (BMI >30 kg/m2) |
ICU admission Mortality-in hospital |
The study did not support the theory of obesity paradox in COVID-19. |
| 5. | Czernichow et al. [44] | Prospective study (n = 5795) in France | RT-PCR | Underweight (<18.5 kg/m2) Normal weight (18.5–25 kg/m2) Overweight (25–30 kg/m2) Obese class I (30–35 kg/m2) Obese class II (35–40 kg/m2) Obese class III (>40 kg/m2) |
Mortality | The study showed that mortality rate was higher in those with obesity. |
| 6. | Abumayyaleh et al. [45] | Retrospective cohort study (n = 3635) | RT-PCR | Obese patients (BMI > 30 kg/m2) | In-hospital morality | It was pointed out the absence of evidence for the obesity paradox in COVID-19 patients. |
| 7. | Schavemaker et al. [46] | Prospective study (n = 1122) Netherland | RT-PCR | Normal weight (18.5–24.9 kg/m2) Overweight (25–29.9 kg/m2) Obese (>30 kg/m2) |
ICU In-hospital morality |
The study was not able to validate the obesity survival paradox in COVID-19 infected patients. |
| 8. | Wolf et al. [47] | Retrospective study (n = 277) in Boston-USA | RT-PCR | Without obesity (BMI ≤ 29.9 kg/m2) Obesity class 1 (30 to 34.9 kg/m2) Obesity class 2 (35 to 39.9 kg/m2) Obesity class 3 (≥40 kg/m2) |
ICU admission Survival |
The obesity was not significant associated with clinical outcomes, the study not being able to demonstrate an obesity survival paradox in COVID-19 infected patients. |
| 9. | Carneiro RAVD et al. [48] | Retrospective study conducted in Brazil | RT-PCR | Overweight (BMI ≥ 25 kg/m2) Obesity (BMI ≥ 30 kg/m2) |
Mortality | There is a positive corelation between obesity and overall mortality. |
| 10. | Foulkes et al. [49] | Retrospective study conducted in USA (n = 3828) | RT-PCR | Obesity (BMI >30 kg/m2) | IMV Mortality |
Obesity increases the systemic inflammation response COVID-19 patients and leads to severe outcomes. |
| 11. | Motaib et al. [50] | Retrospective study in Morocco (n = 107) | RT-PCR | Obesity (BMI ≥ 30 kg/m2) | ICU admission | Obesity is independently associated with an increased rate of ICU admission. |
| 12. | Sidhu et al. [51] | Retrospective study (n = 425) in New Orleans, USA | RT-PCR | Obesity (BMI >30 kg/m2) Severe obesity (≥35 kg/m2 and < 40 kg/ m2) Morbid obesity (>40.0 kg/m2) |
Mortality | COVID-19 obese patients with at least one obesity related condition have an increased risk of death. |
| 13. | Yates et al. [52] | Retrospective study (n = 412,596) in UK | RT-PCR | Normal weight (18.5 to 24.9 kg/m2) Overweight (25.0 to 29.9 kg/m2) Obesity (BMI ≥ 30 kg/m2) |
Mortality | Obesity is associate with a higher rate of Mortality |