117: Obesity Is a Risk Factor for Increased COVID-19 Severity: A Systemic Review and Meta-Regression

INTRODUCTION: Learning objective: The primary objective of this review is to examine studies reporting association of mortality in COVID-19 patients with obesity A secondary objective is to similarly assess associations with higher severity of the disease in COVID-19 patients in regards with obesity METHODS: We searched multiple COVID-19 databases (WHO, CDC, LIT-COVID) for randomized trials and longitudinal studies from all over the world reporting mortality and severity published before July 18th, 2020 Meta-analyses were performed using 6 studies for mortality outcome comparison and 24 for the severity outcome Mantel-Haenszel odds ratios were generated to describe the overall effect side using random effect models To account for between study results variations, multivariate meta-regression was performed with pre-selected covariates using maximum likelihood method for both the mortality and severity models RESULTS: Our findings showed the presence of obesity did not significantly influence mortality (Mantel-Haenszel OR=1 16, 95% CI 0 67 to 2 007, p=0 59, I2= 96 12%) However, obese patients were likely to have severe disease (Mantel-Haenszel OR=1 56, 95% CI 1 32 to 1 84, I2=58 7%) in comparison to not being on ACEI/ARBs in COVID-19 positive patients Multivariate meta-regression for the severity model demonstrated that 100% of between study variation could be explained by differences in proportion of diabetes, pulmonary disease, hypertension and age CONCLUSIONS: We found that obesity leads to significantly increased severity of COVID-19 but has no association with mortality Therefore, the inclusion of body mass index in prognostic scores and improvement of guidelines for the intensive care of patients with obesity are highly recommended