Effect of increased BMI and obesity on the outcome of COVID-19 adult patients: A systematic review and meta-analysis

Background and aims Corona virus diseases 2019 (COVID-19) pandemic spread rapidly Growing evidences that overweight and obesity which extent nearly a third of the world population were associated with severe COVID-19 This study aimed to explore the association and risk of increased BMI and obesity with composite poor outcome in COVID-19 adult patients Methods We conducted a systematic literature search from PubMed and Embase database We included all original research articles in COVID-19 adult patients and obesity based on classification of Body Mass Index (BMI) and composite poor outcome which consist of ICU admission, ARDS, severe COVID-19, use of mechanical ventilation, hospital admission, and mortality Results Sixteen studies were included in meta-analysis with 9 studies presented BMI as continuous outcome and 10 studies presented BMI as dichotomous outcome (cut-off ≥30 kg/m2) COVID-19 patients with composite poor outcome had higher BMI with mean difference 1 12 (95% CI, 0 67–1 57, P < 0 001) Meanwhile, obesity was associated with composite poor outcome with odds ratio (OR) = 1 78 (95% CI, 1 25–2 54, P < 0 001) Multivariate meta-regression showed the association between BMI and obesity on composite poor outcome were affected by age, gender, DM type 2, and hypertension Conclusion Obesity is a risk factor of composite poor outcome of COVID-19 On the other hand, COVID-19 patients with composite poor outcome have higher BMI BMI is an important routine procedure that should always be assessed in the management of COVID-19 patients and special attention should be given to patients with obesity