Association of body mass index (BMI) with critical COVID-19 and in-hospital mortality: A dose-response meta-analysis
Association of body mass index (BMI) with critical COVID-19 and in-hospital mortality: A dose-response meta-analysis
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DOI：
10.1016/j.metabol.2020.154373
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发表时间：
2021-01-19
影响因子：
9.8
通讯作者：
Hong, Xiuqin
中科院分区：
文献类型：
--
作者：
Du, Yanbin;Lv, Yuan;Hong, Xiuqin
背景及目的：2019冠状病毒病（COVID-19）大流行为全世界带来前所未有的健康危机。据报道，身体质量指数（BMI）可能在COVID-19中发挥重要作用;然而，这仍然不清楚。本研究的目的是探讨BMI与COVID-19严重程度和死亡率之间的关系。方法：系统检索Medline，PubMed，Embase和Web of science，直至2020年8月。随机效应模型和剂量反应荟萃分析被用来综合结果。计算合并优势比（OR）及其95%置信区间（CI），并使用亚组分析和荟萃回归分析协变量的影响。结果：共纳入16项观察性研究，涉及109，881例COVID-19患者。汇总结果显示，BMI >-30 kg/m2的患者，（OR = 2.35，95%CI = 1.64-3.38，P < 0.001）为危重COVID-19和2.68倍的COVID-19死亡风险（OR = 2.68，95%CI = 1.65-4.37，P < 0.001）与BMI> 60岁的患者相比，（OR = 3.11，95%CI = 1.73-5.61，P < 0.001）和COVID-19死亡率（OR = 3.93，95%CI = 2.18-7.09，P < 0.001）。荟萃回归分析结果还显示，年龄对BMI与COVID-19死亡率之间的关联有显著影响（Coef. = 0.036，P = 0.048）。随机效应剂量反应荟萃分析显示，BMI与临界COVID-19（P非线性= 0.242）和死亡率（P非线性= 0.116）之间存在线性相关。重症COVID-19的风险和死亡率增加了9%（OR = 1.09，95%CI = 1.04-1.14，P < 0.001）和6%（OR = 1.06，95%CI = 1.02-1.10，P = 0.002）。结论：这项荟萃分析的证据表明，BMI与COVID-19严重程度和死亡率之间存在线性剂量反应关系。此外，肥胖（BMI >-30 kg/m2）与严重COVID-19和COVID-19住院死亡率的风险显著增加相关。(C)2020由Elsevier Inc.出版。
Background and purpose: The coronavirus disease 2019 (COVID-19) pandemic presents an unprecedented health crisis to the entire world. As reported, the body mass index (BMI) may playan important role in COVID-19; however, this still remains unclear. The aim of this study was to explore the association between BMI and COVID-19 severity and mortality.Methods: The Medline, PubMed, Embase and Web of science were systematically searched until August 2020. Random-effects models and dose-response meta-analysis were used to synthesize the results. Combined odds ratios (ORs) with their 95% confidence intervals (CIs) were calculated, and the effect of covariates were analyzed using subgroup analysis and meta-regression analyses.Results: A total of 16 observational studies involving 109,881 patients with COVID-19 were included in the meta -analysis. The pooled results showed that patients with a BMI >-30 kg/m(2) had a 2.35-fold risk (OR = 2.35, 95%CI = 1.64-3.38, P < 0.001) for critical COVID-19 anda 2.68-fold risk for COVID-19 mortality (OR = 2.68, 95%CI = 1.65-4.37, P < 0.001) compared with patients with a BMI 60 years was associated with a significantly increased risk of critical COVID-19 (OR = 3.11, 95%CI = 1.73-5.61, P < 0.001) and COVID-19 mortality (OR = 3.93, 95%CI = 2.18-7.09, P < 0.001). Meta-regression analysis results also showed that age had a significant influence on the association between BMI and COVID-19 mortality (Coef. = 0.036, P = 0.048). Random-effects dose-response meta-analysis showed a linear association between BMI and both critical COVID-19(Pnon-linearity = 0.242) and mortality (Pnon-linearity = 0.116). The risk of critical COVID-19 and mortality increased by 9%(OR = 1.09, 95%CI = 1.04-1.14, P < 0.001) and 6%(OR = 1.06, 95%CI = 1.02-1.10, P = 0.002) for each 1 kg/m2 increase in BMI, respectively.Conclusions: Evidence from this meta-analysis suggested that a linear dose-response association between BMI and both COVID-19 severity and mortality. Further, obesity (BMI >-30 kg/m2) was associated with a significantly increased risk of critical COVID-19 and in-hospital mortality of COVID-19. (C) 2020 Published by Elsevier Inc.