Top

BMC Public Health

Published in:

01-12-2021 | Obesity | Research article

Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis

Authors: Zixin Cai, Yan Yang, Jingjing Zhang

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic has led to global research to predict those who are at greatest risk of developing severe disease and mortality. The aim of this meta-analysis was to determine the associations between obesity and the severity of and mortality due to COVID-19.

Methods

We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies evaluating the associations of obesity with COVID-19.

Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Meta-regression analyses were conducted to estimate regression coefficients.

Results

Forty-six studies involving 625,153 patients were included. Compared with nonobese patients, obese patients had a significantly increased risk of infection.

(OR 2.73, 95% CI 1.53–4.87; I² = 96.8%), hospitalization (OR 1.72, 95% CI 1.55–1.92; I² = 47.4%), clinically severe disease (OR 3.81, 95% CI 1.97–7.35; I² = 57.4%), mechanical ventilation (OR 1.66, 95% CI 1.42–1.94; I² = 41.3%), intensive care unit (ICU) admission (OR 2.25, 95% CI 1.55–3.27; I² = 71.5%), and mortality (OR 1.61, 95% CI 1.29–2.01; I² = 83.1%).

Conclusion

Patients with obesity may have a greater risk of infection, hospitalization, clinically severe disease, mechanical ventilation, ICU admission, and mortality due to COVID-19. Therefore, it is important to increase awareness of these associations with obesity in COVID-19 patients.

Available only for authorised users

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.CrossRefPubMedPubMedCentral

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–42. https://doi.org/10.1001/jama.2020.2648.CrossRefPubMed

Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology. 2020;296(2):E15–25. https://doi.org/10.1148/radiol.2020200490.CrossRefPubMed

Li Q, Hwang LC. Strategies for selecting/switching chemotherapy and supportive care treatments during COVID-19 outbreak. Cancer Med. 2020;9(17):6079–81. https://doi.org/10.1002/cam4.3314.CrossRefPubMedPubMedCentral

Kinross P, et al. Rapidly increasing cumulative incidence of coronavirus disease (COVID-19) in the European Union/European economic area and the United Kingdom, 1 January to 15 March 2020. Euro Surveill. 2020;25(11):2000285. https://doi.org/10.2807/1560-7917.ES.2020.25.11.2000285.

Michael DR, Jack AA, Masetti G, Davies TS, Loxley KE, Kerry-Smith J, et al. A randomised controlled study shows supplementation of overweight and obese adults with lactobacilli and bifidobacteria reduces bodyweight and improves well-being. Sci Rep. 2020;10(1):4183. https://doi.org/10.1038/s41598-020-60991-7.CrossRefPubMedPubMedCentral

Frydrych LM, Bian G, O'Lone DE, Ward PA, Delano MJ. Obesity and type 2 diabetes mellitus drive immune dysfunction, infection development, and sepsis mortality. J Leukoc Biol. 2018;104(3):525–34. https://doi.org/10.1002/JLB.5VMR0118-021RR.CrossRefPubMed

Talbot HK, Coleman LA, Crimin K, Zhu Y, Rock MT, Meece J, et al. Association between obesity and vulnerability and serologic response to influenza vaccination in older adults. Vaccine. 2012;30(26):3937–43. https://doi.org/10.1016/j.vaccine.2012.03.071.CrossRefPubMedPubMedCentral

Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med. 2018;12(9):755–67. https://doi.org/10.1080/17476348.2018.1506331.CrossRefPubMedPubMedCentral

10.

Zachariah P, et al. Epidemiology, Clinical Features, and Disease Severity in Patients With Coronavirus Disease 2019 (COVID-19) in a Children's Hospital in New York City, New York. JAMA Pediatr. 2020;174(10):e202430. https://doi.org/10.1001/jamapediatrics.2020.2430.CrossRefPubMed

11.

Zheng KI, Gao F, Wang XB, Sun QF, Pan KH, Wang TY, et al. Letter to the editor: obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease. Metabolism. 2020;108:154244. https://doi.org/10.1016/j.metabol.2020.154244.CrossRefPubMedPubMedCentral

12.

Huang R, Zhu L, Xue L, Liu L, Yan X, Wang J, et al. Clinical findings of patients with coronavirus disease 2019 in Jiangsu province, China: a retrospective, multi-center study. PLoS Negl Trop Dis. 2020;14(5):e0008280. https://doi.org/10.1371/journal.pntd.0008280.CrossRefPubMedPubMedCentral

13.

Ong S, et al. Association of higher body mass index (BMI) with severe coronavirus disease 2019 (COVID-19) in younger patients. Clin Infect Dis. 2020;71(16):2300–2. https://doi.org/10.1093/cid/ciaa548.CrossRefPubMed

14.

Swartz MK. The PRISMA statement: a guideline for systematic reviews and meta-analyses. J Pediatr Health Care. 2011;25(1):1–2. https://doi.org/10.1016/j.pedhc.2010.09.006.CrossRefPubMed

15.

Zhang Z, Wu P, Zhang J, Wang S, Zhang G. The effect of statins on microalbuminuria, proteinuria, progression of kidney function, and all-cause mortality in patients with non-end stage chronic kidney disease: a meta-analysis. Pharmacol Res. 2016;105:74–83. https://doi.org/10.1016/j.phrs.2016.01.005.CrossRefPubMed

16.

Hernández-Garduño E. Obesity is the comorbidity more strongly associated for Covid-19 in Mexico. A case-control study. Obes Res Clin Pract. 2020;14(4):375–9. https://doi.org/10.1016/j.orcp.2020.06.001.CrossRefPubMedPubMedCentral

17.

Bello-Chavolla OY, et al. Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico. J Clin Endocrinol Metab. 2020;105(8):dgaa346. https://doi.org/10.1210/clinem/dgaa346.

18.

de Lusignan S, Dorward J, Correa A, Jones N, Akinyemi O, Amirthalingam G, et al. Risk factors for SARS-CoV-2 among patients in the Oxford Royal College of general practitioners research and surveillance Centre primary care network: a cross-sectional study. Lancet Infect Dis. 2020;20(9):1034–42. https://doi.org/10.1016/S1473-3099(20)30371-6.CrossRefPubMedPubMedCentral

19.

Lemyze M, Courageux N, Maladobry T, Arumadura C, Pauquet P, Orfi A, et al. Implications of obesity for the Management of Severe Coronavirus Disease 2019 pneumonia. Crit Care Med. 2020;48(9):e761–7. https://doi.org/10.1097/CCM.0000000000004455.CrossRefPubMed

20.

Toussie D, Voutsinas N, Finkelstein M, Cedillo MA, Manna S, Maron SZ, et al. Clinical and chest radiography features determine patient outcomes in young and middle-aged adults with COVID-19. Radiology. 2020;297(1):E197–206. https://doi.org/10.1148/radiol.2020201754.CrossRefPubMed

21.

Elias M, Pievani D, Randoux C, Louis K, Denis B, Delion A, et al. COVID-19 infection in kidney transplant recipients: disease incidence and clinical outcomes. J Am Soc Nephrol. 2020;31(10):2413–23. https://doi.org/10.1681/ASN.2020050639.CrossRefPubMedPubMedCentral

22.

Brandt JS, et al. Epidemiology of coronavirus disease 2019 in pregnancy: risk factors and associations with adverse maternal and neonatal outcomes. Am J Obstet Gynecol. 2021;224(4):389.e1-389.e9. https://doi.org/10.1016/j.ajog.2020.09.043.

23.

Wang B, van Oekelen O, Mouhieddine TH, del Valle DM, Richter J, Cho HJ, et al. A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward. J Hematol Oncol. 2020;13(1):94. https://doi.org/10.1186/s13045-020-00934-x.CrossRefPubMedPubMedCentral

24.

Killerby ME, Link-Gelles R, Haight SC, Schrodt CA, England L, Gomes DJ, et al. Characteristics associated with hospitalization among patients with COVID-19 - metropolitan Atlanta, Georgia, march-April 2020. MMWR Morb Mortal Wkly Rep. 2020;69(25):790–4. https://doi.org/10.15585/mmwr.mm6925e1.CrossRefPubMedPubMedCentral

25.

Hamer M, et al. Lifestyle Risk Factors for Cardiovascular Disease in Relation to COVID-19 Hospitalization: A Community-Based Cohort Study of 387,109 Adults in UK. medRxiv. 2020; https://doi.org/10.1101/2020.05.09.20096438.

26.

Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and mortality among black patients and white patients with Covid-19. N Engl J Med. 2020;382(26):2534–43. https://doi.org/10.1056/NEJMsa2011686.CrossRefPubMed

27.

Petrilli CM, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in new York City: prospective cohort study. BMJ. 2020;369:m1966.CrossRefPubMedPubMedCentral

28.

Louapre C, et al. Clinical characteristics and outcomes in patients with coronavirus disease 2019 and multiple sclerosis. JAMA Neurol. 2020;77(9):1–10.CrossRefPubMedCentral

29.

Buckner FS, et al. Clinical features and outcomes of 105 hospitalized patients with COVID-19 in Seattle, Washington.Clin Infect Dis. 2020;71(16):2167-73. https://doi.org/10.1093/cid/ciaa632.

30.

Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 severity in a designated Hospital in Shenzhen, China. Diabetes Care. 2020;43(7):1392–8. https://doi.org/10.2337/dc20-0576.CrossRefPubMed

31.

Hu L, et al. Risk factors associated with clinical outcomes in 323 COVID-19 hospitalized patients in Wuhan, China. Clin Infect Dis. 2020;71(16):2089-98. https://doi.org/10.1093/cid/ciaa539.

32.

Deng M, Qi Y, Deng L, Wang H, Xu Y, Li Z, et al. Obesity as a potential predictor of disease severity in young COVID-19 patients: a retrospective study. Obesity (Silver Spring). 2020;28(10):1815–25. https://doi.org/10.1002/oby.22943.CrossRef

33.

Hashemi N, Viveiros K, Redd WD, Zhou JC, McCarty TR, Bazarbashi AN, et al. Impact of chronic liver disease on outcomes of hospitalized patients with COVID-19: a multicentre United States experience. Liver Int. 2020;40(10):2515–21. https://doi.org/10.1111/liv.14583.CrossRefPubMed

34.

Di Bella S, et al. Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: A multicentric prospective evaluation. Diabetes Metab Res Rev. 2021;37(1):e3354. https://doi.org/10.1002/dmrr.3354.

35.

Hajifathalian K, Kumar S, Newberry C, Shah S, Fortune B, Krisko T, et al. Obesity is associated with worse outcomes in COVID-19: analysis of early Data from new York City. Obesity (Silver Spring). 2020;28(9):1606–12. https://doi.org/10.1002/oby.22923.CrossRef

36.

Busetto L, Bettini S, Fabris R, Serra R, Dal Pra C, Maffei P, et al. Obesity and COVID-19: an Italian snapshot. Obesity (Silver Spring). 2020;28(9):1600–5. https://doi.org/10.1002/oby.22918.CrossRef

37.

Kalligeros M, et al. Association of Obesity with Disease Severity Among Patients with Coronavirus Disease 2019. Obesity (silver Spring). 2020;28(7):1200–4.CrossRef

38.

Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al. High prevalence of obesity in severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity (Silver Spring). 2020;28(7):1195–9. https://doi.org/10.1002/oby.22831.CrossRef

39.

Nakeshbandi M, Maini R, Daniel P, Rosengarten S, Parmar P, Wilson C, et al. The impact of obesity on COVID-19 complications: a retrospective cohort study. Int J Obes. 2020;44(9):1832–7. https://doi.org/10.1038/s41366-020-0648-x.CrossRef

40.

Ortiz-Brizuela E, Villanueva-Reza M, González-Lara MF, Tamez-Torres KM, Román-Montes CM, Díaz-Mejía BA, et al. Clinical and epidemiological characteristics of patients diagnosed with COVID-19 in a tertiary care center in Mexico City: a prospective cohort study. Rev Investig Clin. 2020;72(3):165–77. https://doi.org/10.24875/RIC.20000211.CrossRef

41.

Suleyman G, Fadel RA, Malette KM, Hammond C, Abdulla H, Entz A, et al. Clinical characteristics and morbidity associated with coronavirus disease 2019 in a series of patients in metropolitan Detroit. JAMA Netw Open. 2020;3(6):e2012270. https://doi.org/10.1001/jamanetworkopen.2020.12270.CrossRefPubMedPubMedCentral

42.

Argenziano MG, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ. 2020;369:m1996.CrossRefPubMedPubMedCentral

43.

Urra JM, Cabrera CM, Porras L, Ródenas I. Selective CD8 cell reduction by SARS-CoV-2 is associated with a worse prognosis and systemic inflammation in COVID-19 patients. Clin Immunol. 2020;217:108486. https://doi.org/10.1016/j.clim.2020.108486.CrossRefPubMedPubMedCentral

44.

Rottoli M, Bernante P, Belvedere A, Balsamo F, Garelli S, Giannella M, et al. How important is obesity as a risk factor for respiratory failure, intensive care admission and death in hospitalised COVID-19 patients? Results from a single Italian Centre. Eur J Endocrinol. 2020;183(4):389–97. https://doi.org/10.1530/EJE-20-0541.CrossRefPubMed

45.

Chao JY, et al. Clinical Characteristics and Outcomes of Hospitalized and Critically Ill Children and Adolescents with Coronavirus Disease 2019 at a Tertiary Care Medical Center in New York City. J Pediatr. 2020;223:14–19.e2.CrossRefPubMedPubMedCentral

46.

Pettit NN, MacKenzie EL, Ridgway JP, Pursell K, Ash D, Patel B, et al. Obesity is associated with increased risk for mortality among hospitalized patients with COVID-19. Obesity (Silver Spring). 2020;28(10):1806–10. https://doi.org/10.1002/oby.22941.CrossRef

47.

Wu X, et al. Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. medRxiv. 2020; https://doi.org/10.1101/2020.04.05.20054502.

48.

Escalera-Antezana JP, Lizon-Ferrufino NF, Maldonado-Alanoca A, Alarcon-de-la-Vega G, Alvarado-Arnez LE, Balderrama-Saavedra MA, et al. Risk factors for mortality in patients with coronavirus disease 2019 (COVID-19) in Bolivia: an analysis of the first 107 confirmed cases. Infez Med. 2020;28(2):238–42.PubMed

49.

Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020;395(10241):1907–18. https://doi.org/10.1016/S0140-6736(20)31187-9.CrossRefPubMedPubMedCentral

50.

Klang E, Kassim G, Soffer S, Freeman R, Levin MA, Reich DL. Severe obesity as an independent risk factor for COVID-19 mortality in hospitalized patients younger than 50. Obesity (Silver Spring). 2020;28(9):1595–9. https://doi.org/10.1002/oby.22913.CrossRef

51.

Giacomelli A, Ridolfo AL, Milazzo L, Oreni L, Bernacchia D, Siano M, et al. 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: a prospective cohort study. Pharmacol Res. 2020;158:104931. https://doi.org/10.1016/j.phrs.2020.104931.CrossRefPubMedPubMedCentral

52.

Docherty AB, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study. BMJ. 2020;369:m1985.CrossRefPubMedPubMedCentral

53.

Palaiodimos L, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262.CrossRefPubMedPubMedCentral

54.

Peng Y, Meng K, He M, Zhu R, Guan H, Ke Z, et al. Clinical characteristics and prognosis of 244 cardiovascular patients suffering from coronavirus disease in Wuhan, China. J Am Heart Assoc. 2020;9(19):e016796. https://doi.org/10.1161/JAHA.120.016796.CrossRefPubMedPubMedCentral

55.

Crespo M, Pérez-Sáez MJ, Redondo-Pachón D, Llinàs-Mallol L, Montero MM, Villar-García J, et al. COVID-19 in elderly kidney transplant recipients. Am J Transplant. 2020;20(10):2883–9. https://doi.org/10.1111/ajt.16096.CrossRefPubMed

56.

Chand S, Kapoor S, Orsi D, Fazzari MJ, Tanner TG, Umeh GC, et al. COVID-19-associated critical illness-report of the first 300 patients admitted to intensive care units at a new York City medical center. J Intensive Care Med. 2020;35(10):963–70. https://doi.org/10.1177/0885066620946692.CrossRefPubMed

57.

Lièvre A, Turpin A, Ray-Coquard I, le Malicot K, Thariat J, Ahle G, et al. Risk factors for coronavirus disease 2019 (COVID-19) severity and mortality among solid cancer patients and impact of the disease on anticancer treatment: a French nationwide cohort study (GCO-002 CACOVID-19). Eur J Cancer. 2020;141:62–81. https://doi.org/10.1016/j.ejca.2020.09.035.CrossRefPubMedPubMedCentral

58.

Fuster JJ, Ouchi N, Gokce N, Walsh K. Obesity-induced changes in adipose tissue microenvironment and their impact on cardiovascular disease. Circ Res. 2016;118(11):1786–807. https://doi.org/10.1161/CIRCRESAHA.115.306885.CrossRefPubMedPubMedCentral

59.

Messina G, et al. Functional Role of Dietary Intervention to Improve the Outcome of COVID-19: A Hypothesis of Work. Int J Mol Sci. 2020;21(9):3104. https://doi.org/10.3390/ijms21093104.

60.

Salvator H, Grassin-Delyle S, Naline E, Brollo M, Fournier C, Couderc LJ, et al. Contrasting effects of Adipokines on the cytokine production by primary human bronchial epithelial cells: inhibitory effects of adiponectin. Front Pharmacol. 2020;11:56. https://doi.org/10.3389/fphar.2020.00056.CrossRefPubMedPubMedCentral

61.

Ali AN, Sood A. Leptin, adiponectin and pulmonary diseases. Biochimie. 2012;94(10):2180–9.CrossRef

62.

Dallinga-Thie GM, Dullaart RP. Do genome-wide association scans provide additional information on the variation of plasma adiponectin concentrations? Atherosclerosis. 2010;208(2):328–9. https://doi.org/10.1016/j.atherosclerosis.2009.12.014.CrossRefPubMed

63.

Gómez-Ambrosi J, Salvador J, Silva C, Pastor C, Rotellar F, Gil M, et al. Increased cardiovascular risk markers in obesity are associated with body adiposity: role of leptin. Thromb Haemost. 2006;95(6):991–6. https://doi.org/10.1160/TH06-02-0079.CrossRefPubMed

64.

Luzi L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic. Acta Diabetol. 2020;57(6):759–64. https://doi.org/10.1007/s00592-020-01522-8.CrossRefPubMedPubMedCentral

65.

Kassir R. Risk of COVID-19 for patients with obesity. Obes Rev. 2020;21(6):e13034. https://doi.org/10.1111/obr.13034.CrossRefPubMedPubMedCentral

66.

De Jong A, Verzilli D, Jaber S. ARDS in obese patients: specificities and management. Crit Care. 2019;23(1):74. https://doi.org/10.1186/s13054-019-2374-0.CrossRefPubMedPubMedCentral

67.

Shore SA. Environmental perturbations: obesity. Compr Physiol. 2011;1(1):263–82. https://doi.org/10.1002/cphy.c100017.CrossRefPubMedPubMedCentral

68.

Hariyanto TI, Kurniawan A. Obstructive sleep apnea (OSA) and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review and meta-analysis. Sleep Med. 2021;82:47–53. https://doi.org/10.1016/j.sleep.2021.03.029.CrossRefPubMedPubMedCentral

69.

Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin N Am. 2003;32(4):869–94. https://doi.org/10.1016/S0889-8529(03)00069-0.CrossRef

70.

Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK. Interactions between obesity and obstructive sleep apnea: implications for treatment. Chest. 2010;137(3):711–9. https://doi.org/10.1378/chest.09-0360.CrossRefPubMedPubMedCentral

71.

Cauberghe V, et al. How adolescents use social media to cope with feelings of loneliness and anxiety during COVID-19 lockdown. Cyberpsychol Behav Soc Netw. 2021;24(4):250-7. https://doi.org/10.1089/cyber.2020.0478.

72.

Bhasker AG, Greve JW. Are patients suffering from severe obesity getting a raw Deal during COVID-19 pandemic? Obes Surg. 2020;30(10):4107–8. https://doi.org/10.1007/s11695-020-04677-z.CrossRefPubMedPubMedCentral

73.

Hawkley LC, Thisted RA, Cacioppo JT. Loneliness predicts reduced physical activity: cross-sectional & longitudinal analyses. Health Psychol. 2009;28(3):354–63. https://doi.org/10.1037/a0014400.CrossRefPubMedPubMedCentral

74.

Drewnowski A. The cost of US foods as related to their nutritive value. Am J Clin Nutr. 2010;92(5):1181–8. https://doi.org/10.3945/ajcn.2010.29300.CrossRefPubMedPubMedCentral

75.

Hall KD, et al. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab. 2019;30(1):67–77.e3.CrossRefPubMedPubMedCentral

76.

Jensen MD, et al. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023.CrossRefPubMed

77.

Egger G. Helping patients lose weight--what works? Aust Fam Physician. 2008;37(1–2):20–3.PubMed

78.

Kruger J, Galuska DA, Serdula MK, Jones DA. Attempting to lose weight: specific practices among U.S. adults. Am J Prev Med. 2004;26(5):402–6. https://doi.org/10.1016/j.amepre.2004.02.001.CrossRefPubMed

79.

Bish CL, Blanck HM, Maynard LM, Serdula MK, Thompson NJ, Khan LK. Health-related quality of life and weight loss practices among overweight and obese US adults, 2003 behavioral risk factor surveillance system. MedGenMed. 2007;9(2):35.PubMedPubMedCentral

80.

Sharma S, Ray A, Sadasivam B. Metformin in COVID-19: a possible role beyond diabetes. Diabetes Res Clin Pract. 2020;164:108183. https://doi.org/10.1016/j.diabres.2020.108183.CrossRefPubMedPubMedCentral

81.

Ursini F, Ciaffi J, Landini MP, Meliconi R. COVID-19 and diabetes: is metformin a friend or foe? Diabetes Res Clin Pract. 2020;164:108167. https://doi.org/10.1016/j.diabres.2020.108167.CrossRefPubMedPubMedCentral

82.

Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303–10. https://doi.org/10.1016/j.dsx.2020.04.004.CrossRefPubMedPubMedCentral

83.

Hui F, Zhang Y, Ren T, Li X, Zhao M, Zhao Q. Role of metformin in overweight and obese people without diabetes: a systematic review and network meta-analysis. Eur J Clin Pharmacol. 2019;75(4):437–50. https://doi.org/10.1007/s00228-018-2593-3.CrossRefPubMed

84.

Stanton R, et al. Depression, Anxiety and Stress during COVID-19: Associations with Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian Adults. Int J Environ Res Public Health. 2020;17(11):4065. https://doi.org/10.3390/ijerph17114065.

85.

Moynihan AB, et al. Eaten up by boredom: consuming food to escape awareness of the bored self. Front Psychol. 2015;6:369.CrossRefPubMedPubMedCentral

Title: Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis
Authors: Zixin Cai
Yan Yang
Jingjing Zhang
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Obesity
Obesity
COVID-19
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11546-6

2024 ASCO Annual Meeting

Springer Medicine

Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis

Abstract

Background

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Developing a whole-school mental health and wellbeing intervention through pragmatic formative process evaluation: a case-study of innovative local practice within The School Health Research network

LiveWell in early childhood: results from a two-year pilot intervention to improve nutrition and physical activity policies, systems and environments among early childhood education programs in South Carolina

Health literacy levels and its determinants among people with asthma in Malaysian primary healthcare settings: a cross-sectional study

Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake

LGBT+ inclusion and human rights in Thailand: a scoping review of the literature

Intervention development of a brief messaging intervention for a randomised controlled trial to improve diabetes treatment adherence in sub-Saharan Africa