Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships

Barry M Popkin, Shufa Du, William D Green, Melinda A Beck, Taghred Algaith, Christopher H Herbst, Reem F Alsukait, Mohammed Alluhidan, Nahar Alazemi, Meera Shekar, Barry M Popkin, Shufa Du, William D Green, Melinda A Beck, Taghred Algaith, Christopher H Herbst, Reem F Alsukait, Mohammed Alluhidan, Nahar Alazemi, Meera Shekar

Abstract

The linkage of individuals with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID-19, 75 studies were used to conduct a series of meta-analyses on the relationship of individuals with obesity-COVID-19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID-19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID-19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30-1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74-2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46-2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22-1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID-19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.

Keywords: COVID-19; individuals with obesity; meta-analysis; vaccination.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2020 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.

Figures

FIGURE 1
FIGURE 1
Prevalence of overweight and obesity based on 1990s and late 2010s weight and height data
FIGURE 2
FIGURE 2
Flowchart for meta‐analysis of the obesity–COVID‐19 relationship
FIGURE 3
FIGURE 3
Meta‐analysis of the association between individuals with obesity and the risk of testing positive for COVID‐19
FIGURE 4
FIGURE 4
Meta‐analysis of the association between individuals with obesity and the risk of hospitalization with COVID‐19
FIGURE 5
FIGURE 5
Meta‐analysis of the association between individuals with obesity and the risk of being placed in an intensive care unit (ICU)
FIGURE 6
FIGURE 6
Meta‐analysis of the association between individuals with obesity and the risk of administration of invasive mechanical ventilation (IMV)
FIGURE 7
FIGURE 7
Meta‐analysis of the association between individuals with obesity and mortality for individuals with COVID‐19
FIGURE 8
FIGURE 8
Clinical manifestations and mechanisms for COVID‐19 risk in individuals with obesity

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