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. 2021 Jun 30;10(1):1–8. doi: 10.17476/jmbs.2021.10.1.1

Table 1. Summary of recent literatures showing the impact of obesity on coronavirus disease 2019 severity.

Country Number of Patients & Prevalence of Obesity Major Findings References
China Total no. of patients: 383,
BMI 28 kg/m2 : 41 (10.7%)		 Increased risk for developing severe pneumonia in BMI 28 kg/m2 (OR, 1.84; 95% CI, 0.99–3.43) Cai et al. (2020) [2]
France Total no. of patients: 291,
BMI 35 kg/m2 : 85 (25%)		 Higher prevalence of obesity in ICU in COVID-19 compared without COVID-19 (OR, 1.69; 95% CI, 1.10–2.56) Caussy et al. (2020) [3]
France Total no. of patients: 124,
BMI 30 kg/m2 : 47.6%
BMI 35 kg/m2 : 28.2%		 Higher requirement for IMV in higher BMI (P< 0.05), greatest in BMI>35 kg/m2 (OR, 7.36; 95% CI, 1.63–33.14) Simonnet et al. (2020) [4]
France Total no. of patients: 5,795,
BMI 30-35; M=318; F=474
BMI 35-40; M=170; F=126
BMI＞40; M=104; F=72		 Higher mortality in BMI of 25–29.9, 30–35, 35–40, and >40 (OR, 1.41, 1.89, 2.79, and 2.55 respectively, even after correction for age, sex, and comorbidities) Czernichow et al. (2020) [5]
Italy Total no. of patients: 140,
BMI 30–35 kg/m2 18 (25%),
BMI 35–40 kg/m2 9 (13%),
BMI>40 kg/m2 2 (3%)		 Higher percentage for ICU care, requiring mechanical ventilation and severe ARDS in patients with BMI 30 kg/m2 (OR, 3.42; 95% CI, 1.79–6.52) Chiumello et al. (2020) [6]
United States Total no. of patients: 5,279,
BMI 25–29; 1,760 (33.5%),
BMI 30–39; 1,554 (29.4%),
BMI>40 kg/m2 311 (5.9%)		 Higher risk for hospital admission for BMI >40 kg/m2: OR, 2.5; 95% CI, 1.8–3.4) and critical illness for BMI >40 kg/m2 (OR, 1.51;95% CI, 1.0 to 2.2) Petrilli et al. (2020) [7]
United States Total no. of patients: 393,
BMI 30 kg/m2 : 136 (35.8%),		 Obesity was a risk factor for respiratory failure leading to invasive mechanical ventilation: obese patients in IMV group; 56/129 (43.4%) vs. in non-IMV group 80/251 (31.9%) Goyal et al. (2020) [8]
United States Total no. of patients: 3,615
Age<60y:
BMI 30–35 kg/m2 : 171 (29%)
BMI 35 kg/m2 : 134 (22%)		 Higher risk for acute and critical care for BMI 35 kg/m2 (OR, 2.0; 95% CI, 1.6–2.6) and critical illness for BMI >40 kg/m2 (OR, 1.51; 95% CI, 1.0 to 2.2), compared to BMI < 30 kg/m2 in patient aged < 60 years. Lighter et al. (2020) [9]
United Kingdom Total no. of patients: 20,133
Obesity: 1,685 (10.5%)		 Higher mortality in obese patients (HR, 1.33; 95% CI, 1.19–1.49) Docherty et al. (2020) [10]
United Kingdom Total no. of patients: 502,655
Overweight: 19.1 per 10,000
BMI 30–35: 23.3 per 10,00
BMI >35: 42.7 per 10,000		 Linear trend of COVID-19 hospitalization with increasing BMI: Overweight (OR, 1.39; 95% CI, 1.13–1.71), BMI 30–35 kg/m2 (1.70;1.34–2.16), BMI >35 kg/m2 (3.38;2.60–4.40) Hamer et al. (2020) [11]
United Kingdom Total no. of patients:
6.9milion (6,910,695)
BMI 30 kg/m2 : 15.5%
BMI 35 kg/m2 : 8.8%		 J-shaped associations between BMI and admission to hospital due to COVID-19 (HR, from the nadir at BMI of 23 kg/m2 of 1.05; 95% CI, 1.05–1.05) and death (HR, 1.04; 95% CI, 1.04–1.05), Gao et al. (2021) [12]
China Total no. of patients: 65 (age: 18-40) divided by COVID-19 severity; Moderate (n=53) vs. Severe (n=12) Higher BMI (29.23 kg/m2) in the patients with severe/critical group compared moderate group (22.79 kg/m2) Deng et al. (2020) [13]
United States Total no. of patients: 3,406,
Survivor vs. non-survivors;
BMI 40 kg/m2, Age 50:
69 (13.5%) vs. 19 (31.7%)		 Higher mortality with BMI40 both in the younger population, (OR, 5.1; 95% CI, 2.3–11.1) and older population (OR 1.6; 95% CI, 1.2–2.3). Klang et al. (2020) [14]
South Korea Total no. of patients: 5,628,
BMI 30 kg/m2 : 47.6%,
BMI 35 kg/m2 : 28.2%		 Higher HR of mortality (HR, 1.71; 95% CI, 1.10–2.66) Kim et al. (2020) [15]

BMI = body mass index, O = odds ratio, CI = confidence interval, ICU = intensive care unit, COVID-19 = coronavirus disease 2019; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), IMV = invasive mechanical ventilation, M = male, F = female, ARDS = acute respiratory distress syndrome, HR = hazard ratio.