Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Diagnosis (Berl). 2020 Nov 19;8(1):5-16. doi: 10.1515/dx-2020-0111. Print 2021 Feb 23.
The worldwide spread of coronavirus disease 2019 (COVID-19) has generated a global health crisis and more than a million deaths so far. Epidemiological and clinical characteristics of COVID-19 are increasingly reported, along with its potential relationship with overweight and/or obesity. Therefore, we aim here to review the current scientific literature on the impact of overweight and/or obesity among hospitalized patients who have developed severe or critical forms of COVID-19. Following PRISMA guidelines, our literature search identified over 300 scientific articles using the keywords "obesity" and "COVID-19", 22 of which were finally selected for reporting useful information on the association between overweight/obesity and disease severity. In particular, in 11 out of the 14 studies (79%) which evaluated the association between obesity and disease severity providing also a risk estimate (i.e., the odd ratio; OR), the OR value was constantly >2. Although the studies were found to be heterogeneous in terms of design, population, sample size and endpoints, in most cases a significant association was found between obesity and the risk of progressing to severe COVID-19 illness, intensive care unit admission and/or death. We can hence conclude that an increased body mass index shall be considered a negative prognostic factor in patients with COVID-19, and more aggressive prevention or treatment shall hence be reserved to overweight and/or obese patients.
2019 年冠状病毒病（COVID-19）在全球范围内的传播引发了全球卫生危机，到目前为止已导致超过 100 万人死亡。COVID-19 的流行病学和临床特征越来越多地被报道，同时也报道了其与超重和/或肥胖的潜在关系。因此，我们旨在回顾目前关于 COVID-19 住院患者中超重和/或肥胖与严重或危急型 COVID-19 之间关系的科学文献。根据 PRISMA 指南，我们使用“肥胖”和“COVID-19”这两个关键词搜索了超过 300 篇科学文章，最终选择了 22 篇报告了与超重/肥胖和疾病严重程度之间关联的有用信息。特别是，在 14 项评估肥胖与疾病严重程度之间关联并提供风险估计（即比值比；OR）的研究中，有 11 项（79%）的 OR 值始终大于 2。尽管这些研究在设计、人群、样本量和终点方面存在异质性，但在大多数情况下，肥胖与进展为严重 COVID-19 疾病、入住重症监护病房和/或死亡的风险之间存在显著关联。因此，我们可以得出结论，体重指数增加应被视为 COVID-19 患者的负面预后因素，超重和/或肥胖患者应采取更积极的预防或治疗措施。
