E1 |
Kalligeros, et al. (2020)(44. Kalligeros M, Shehadeh F, Mylona EK, Benitez G, Beckwith CG, Chan PA, et al. Association of obesity with disease severity among patients with coronavirus disease 2019. Obesity (Silver Spring). 2020;28(7):1200–4.)
|
Embase |
USA |
Cohort Retrospective Level IV |
- 103 patients hospitalized by COVID-19. - February 17 to April 5, 2020. -The prevalence of obesity was 47.5% (49 out of 103). -In a multivariate analysis, severe obesity (BMI ≥ 35 kg/m2) was associated with admission to the Intensive Care Unit (adjusted Odds Ratio [OR]: 5.39, 95% CI: 1.13‐25.64). -Patients requiring invasive mechanical ventilation were more likely to be obese (BMI = 30‐34.9 kg/m2; aOR: 6.85, 95% CI: 1.05‐ 44.82) or severe obesity (BMI ≥ 35 kg/m2; aOR: 9.99, 95% CI: 1.39-71.69). |
E2 |
Hur et al. (2020)(1414. Hur K, Price CP, Gray EL, Gulati RK, Maksimoski M, Racette SD, et al. Factors associated with intubation and prolonged intubation in hospitalized patients with COVID-19. Otolaryngol Head Neck Surg. 2020;163(1):170–8.)
|
PubMed |
Chicago - USA |
Observational Level VI |
- 564 patients hospitalized between March 1 and April 8, 2020 positive for COVID-19. -Age, males and history of diabetes were independent risk factors associated with intubation in patients hospitalized with COVID-19 in the Chicago metropolitan area. -The time for extubation was influenced only by age and obesity. Patients intubated with COVID-19 with BMI from 30 to 39.99 (HR, 0.53; 95%, 0.32-0.90) or ≥40 (HR, 0.40; 95%, 0.19-0.82 CI) were associated with a lower chance of extubation compared to patients with a <30. |
E3 |
Docherty AB, et al. (2020)(1515. Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee J, Plotkin D, Sigfrid L, Halpin S, Jackson C, Gamble C, Horby PW, Nguyen-Van-Tam JS, Ho A, Russell CD, Dunning J, Openshaw PJ, Baillie JK, Semple MG; ISARIC4C investigators. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterization Protocol: prospective observational cohort study. BMJ. 2020;369:m1985.)
|
PubMed |
United Kingdom |
Prospective Cohort Level IV |
-20,133 patients hospitalized with COVID-19 between February 6 and April 19. -The factors associated with hospital mortality were increased age, males, obesity (Risk Ratio 1.33; CI 95% 1.19 to 1.49; P<0, 001) and important comorbidities. |
E4 |
Cummings, et al. (2020)(1616. Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763–70.)
|
PubMed |
New York - USA |
Prospective Cohort Level IV |
-257 adults in serious condition of COVID-19 between 2 March and 1 April 2020. - 119 (46%) patients were obese (BMI ≥30 kg/m2), including 39 (71%) of the 55 patients under 50 years old - Severe obesity (BMI ≥40 kg/m2) was not identified as an independent risk factor for mortality. |
E5 |
Palaiodimos, et al. (2020)(1717. Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, 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.)
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Scopus |
Bronx, New York- USA |
Cohort Retrospective Level IV |
-200 patients who attended the emergency room from March 9 to April 12, 2020. - 24% of the cohort died during hospitalization, with higher rates among individuals with severe obesity (BMI <25 kg/m2: 31.6%, BMI 25-34 kg/m2: 17.2%, BMI ≥ 35 kg/m2: 34.8%, p= 0.030). - Patients with severe obesity were more likely to suffer intubation (BMI <25 kg/m2: 18.4%, BMI 25-34 kg/m2: 16.4%, BMI ≥ 35 kg/m2: 34.8%, p= 0.032). - Severe obesity BMI ≥ 35 kg/m2 (OR: 3.09; 95% CI: 1.43–6.69; p= 0.004), increasing age, males and smoking were also independently associated with increased oxygen requirements during hospitalization. |
E6 |
Richardson et al. (2020)(1818. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al.; the Northwell COVID-19 Research Consortium. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020;323(20):2052–9.)
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Scopus |
New York - USA |
Observational Level VI |
- A total of 5,700 patients (median age 63 years) were included from March 1 to April 4, 2020. The most common comorbidities were hypertension (3026; 56.6%), obesity (1737; 41.7%), and diabetes (1808; 33.8%). |
E7 |
Hamer, et al. (2020)(1919. Hamer M, Kivimäki M, Gale CR, Batty GD. Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK. Brain Behav Immun. 2020;87:184–7.)
|
Scopus |
England |
Prospective Cohort Level IV |
-387,109 people. Of these, 760 were hospitalized by COVID-19. -March 16 to April 26, 2020. - 23.5% were obese. - There was a dose-dependent association between the risk of COVID-19 and the worsening of lifestyle scores so that participants, in the most unfavorable category, had a four-fold higher risk (RR = 4.41; CI 95%, 2.52, 7.71). - After adjusting for age, sex and mutually for each lifestyle factor, sedentary lifestyle (RR 1.32, 95% CI, 1.10, 1.58), smoking (RR 1.42; 95% CI 1.12, 1.79) and obesity (RR 2.05; CI95% 1.68, 2.49) were associated with COVID-19. -Unhealthy behaviors in combination (smoking, inactivity, overweight and obesity) represented up to 51% of the fraction attributable to the severe COVID-19 population. - Overweight and obesity are risk factors for severe COVID-19 infection. |
E8 |
Klang, et al. (2020)(2020. 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.)
|
Embase |
New York - USA |
Observational Level VI |
-3,406 patients were included; 572 were under 50. -March 1 and May 17, 2020. - For the younger population, BMI above 40 kg/m2was independently associated with mortality (OR 5.1, 95% CI 2.3-11.1). -For the elderly population, BMI above 40 kg/m2 was also independently associated with mortality to a lesser degree (OR 1.6, 95%CI 1.2 - 2.3). |
E9 |
Cai, et al. (2020)(2121. Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, He Q, Wang Z, Liu Y, Liu L, Chen J, Xu L. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care. 2020;43(7):1392-8.)
|
Embase |
China |
Observational Level VI |
- 383 patients with COVID-19 hospitalized from January 11 to February 16, 2020. - After adjustments for potential confounding factors, those who were overweight (BMI between 24-27.9 kg/m2) had chances of 1.84 times of developing severe COVID-19 (OR 1.84, CI95% 0.99-3.43, p5 0.05), while obese (BMI ≥28 kg/m2) had a 3.40-fold chance of developing severe disease (OR 3.40, 95% CI 1.40-2.86, P5 0.007). |