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      Obesity and mortality of COVID-19. Meta-analysis

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          Abstract

          Background

          Obesity is a global disease with at least 2.8 million people dying each year as a result of being overweight or obese according to the world health organization figures. This paper aims to explore the links between obesity and mortality in COVID-19.

          Methods

          Electronic search was made for the papers studying obesity as a risk factor for mortality following COVID-19 infection. Three authors independently selected the papers and agreed for final inclusion. The outcomes were the age, gender, body mass index, severe comorbidities, respiratory support and the critical illness related mortality in COVID-19. 572 publications were identified and 42 studies were selected including one unpublished study data. Only 14 studies were selected for quantitative analysis.

          Results

          All the primary points but the gender are significantly associated with COVID-19 mortality. The age >70, [odd ratio (OR): 0.17, CI; 95%, P-value: <0.00001], gender [OR: 0.89; CI: 95%, P-value: 0.32], BMI > 25 kg/m 2 [OR: 3.68, CI: 95%, P-value: <0.003], severe comorbidities [OR: 1.84, CI:95%, P-value: <0.00001], advanced respiratory support [OR: 6.98, CI: 95%, P-value: <0.00001], and critical illness [OR: 2.03, CI: 95%, P-value: <0.00001].

          Conclusions

          Patients with obesity are at high risk of mortality from COVID-19 infection.

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          Most cited references31

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy

            In December 2019, a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) emerged in China and has spread globally, creating a pandemic. Information about the clinical characteristics of infected patients who require intensive care is limited.
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              Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan

              Background In December 2019, COVID-19 outbreak occurred in Wuhan. Data on the clinical characteristics and outcomes of patients with severe COVID-19 are limited. Objective The severity on admission, complications, treatment, and outcomes of COVID-19 patients were evaluated. Methods Patients with COVID-19 admitted to Tongji Hospital from January 26, 2020 to February 5, 2020 were retrospectively enrolled and followed-up until March 3, 2020. Potential risk factors for severe COVID-19 were analyzed by a multivariable binary logistic model. Cox proportional hazard regression model was used for survival analysis in severe patients. Results We identified 269 (49.1%) of 548 patients as severe cases on admission. Elder age, underlying hypertension, high cytokine levels (IL-2R, IL-6, IL-10, and TNF-a), and high LDH level were significantly associated with severe COVID-19 on admission. The prevalence of asthma in COVID-19 patients was 0.9%, markedly lower than that in the adult population of Wuhan. The estimated mortality was 1.1% in nonsevere patients and 32.5% in severe cases during the average 32 days of follow-up period. Survival analysis revealed that male, elder age, leukocytosis, high LDH level, cardiac injury, hyperglycemia, and high-dose corticosteroid use were associated with death in patients with severe COVID-19. Conclusions Patients with elder age, hypertension, and high LDH level need careful observation and early intervention to prevent the potential development of severe COVID-19. Severe male patients with heart injury, hyperglycemia, and high-dose corticosteroid use may have high risk of death.
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                Author and article information

                Contributors
                Journal
                Obes Res Clin Pract
                Obes Res Clin Pract
                Obesity Research & Clinical Practice
                Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd.
                1871-403X
                1871-403X
                9 July 2020
                9 July 2020
                Affiliations
                [a ]Doncaster and Bassetlaw Teaching Hospitals, Doncaster, UK,Honorary Lecturer at Sheffield University.Sheffield.UK
                [b ]Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, UK
                [c ]Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province, China
                [d ]The First Affiliated Hospital of Jinan University, 613 Huangpu Avenue West, Guangzhou, Guangdong Province, China
                [e ]Bariatric Unit, Princess Royal University Hospital, King’s College Hospitals NHS Foundation Trust, London, UK
                Author notes
                [* ]Corresponding author. abdulzahra.hussain@ 123456nhs.net
                Article
                S1871-403X(20)30550-0
                10.1016/j.orcp.2020.07.002
                7346803
                32660813
                2f95449f-eb34-4d7e-ab77-72c6757bb72e
                © 2020 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 28 June 2020
                : 2 July 2020
                Categories
                Article

                obesity,covid-19,world health organization,mortality,intensive care unit,body mass index,total body weight

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