• Silvia Helena de Carvalho Sales-Peres, Lucas José de Azevedo-Silva, Rafaela Carolina Soares Bonato, Matheus de Carvalho Sales-Peres, Ana Carolina da Silvia Pinto, and Joel Ferreira Santiago Junior.
• Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, Brazil. Electronic address: shcperes@usp.br.
• Obes Res Clin Pract. 2020 Sep 1; 14 (5): 389-397.

ObjectivesTo investigate the relationship between coronavirus disease 2019 (COVID-19) and obesity in critically ill patients admitted to the intensive care unit (ICU).MethodsWe systematically searched PubMed, SCOPUS, Embase, LILACS, and Web of Science for studies published up to April 27, 2020. The outcome of interest was composite poor outcome, comprising mortality and severe COVID-19. We used a standardized data extraction form to collect information from published reports of eligible studies. Heterogeneity and publication bias were assessed using I2 statistic and funnel plots, respectively.ResultsNine studies including 6577 patients were selected for evaluation. The COVID-19 patients were 59.80% male and had comorbidities such as hypertension (51.51%), diabetes (30.3%), cardiovascular disease (16.66%), lung disease (15.99%), renal disease (7.49%), cancer (5.07%), and immunosuppression (1.8%). For patients with severe complications, the overall pooled event rates were 56.2% (random; 95% CI: 35.3-75.1; p = 0.015; I2 = 71.461) for obesity, 23.6% (random; 95% CI: 17.9-30.5; p = 0.000; I2 = 87.705) for type 2 diabetes, 45.9% (random; 95% CI: 38.0-53.9; p = 0.000; I2 = 90.152) for hypertension, 20.0% (random; 95% CI: 7.9-42.0; p = 0.000; I2 = 94.577) for smoking, 21.6% (random; 95% CI: 14.1-31.4%; p = 0.000, I2 = 92.983) for lung diseases, and 20.6% (random; 95% CI: 15.2-27.5; p = 0.000, I2 = 85.735) for cardiovascular diseases.DiscussionThis systematic review indicated the relationship between obesity, ICU admission, severe COVID-19, and disease progression in patients with COVID-19. Obese patients with hypertension, type 2 diabetes, smoking habit, lung disease, and/or cardiovascular disease should be cared for with increased attention.Copyright © 2020 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

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