TY - JOUR
T1 - Visceral adiposity, subcutaneous adiposity, and severe coronavirus disease-2019 (COVID-19)
T2 - Systematic review and meta-analysis
AU - Pranata, Raymond
AU - Lim, Michael Anthonius
AU - Huang, Ian
AU - Yonas, Emir
AU - Henrina, Joshua
AU - Vania, Rachel
AU - Lukito, Antonia Anna
AU - Nasution, Sally Aman
AU - Alwi, Idrus
AU - Siswanto, Bambang Budi
N1 - Publisher Copyright:
© 2021 European Society for Clinical Nutrition and Metabolism
PY - 2021/6
Y1 - 2021/6
N2 - Background and aims: Body mass index (BMI) has previously been shown to increase mortality and disease severity in patients with COVID-19, but the pooled effect estimate was heterogeneous. Although BMI is widely used as an indicator, it cannot distinguish visceral from subcutaneous fat. This systematic review and meta-analysis aimed to investigate the association between visceral adiposity, subcutaneous fat, and severe COVID-19. Methods: We performed a systematic literature search using the databases: PubMed, Embase, and EuropePMC. Data on visceral fat area (VTA), subcutaneous fat area (SFA), and total fat area (TFA) were collected. The outcome of interest was severe COVID-19. We used a REML random-effects model to pool the mean differences and odds ratio (OR). Results: There were 5 studies comprising of 539 patients. Patients with severe COVID-19 have a higher VTA (mean difference 41.7 cm2 [27.0, 56.4], p < 0.001; I2: 0%) and TFA (mean difference 64.6 cm2 [26.2, 103.1], p = 0.001; I2: 0%). There was no significant difference in terms of SFA between patients with severe and non-severe COVID-19 (mean difference 9.3 cm2 [-4.9, 23.4], p = 0.199; I2: 1.2%). Pooled ORs showed that VTA was associated with severe COVID-19 (OR 1.9 [1.1, 2.2], p = 0.002; I2: 49.3%). Conclusion: Visceral adiposity was associated with increased COVID-19 severity, while subcutaneous adiposity was not. Prospero id: CRD42020215876.
AB - Background and aims: Body mass index (BMI) has previously been shown to increase mortality and disease severity in patients with COVID-19, but the pooled effect estimate was heterogeneous. Although BMI is widely used as an indicator, it cannot distinguish visceral from subcutaneous fat. This systematic review and meta-analysis aimed to investigate the association between visceral adiposity, subcutaneous fat, and severe COVID-19. Methods: We performed a systematic literature search using the databases: PubMed, Embase, and EuropePMC. Data on visceral fat area (VTA), subcutaneous fat area (SFA), and total fat area (TFA) were collected. The outcome of interest was severe COVID-19. We used a REML random-effects model to pool the mean differences and odds ratio (OR). Results: There were 5 studies comprising of 539 patients. Patients with severe COVID-19 have a higher VTA (mean difference 41.7 cm2 [27.0, 56.4], p < 0.001; I2: 0%) and TFA (mean difference 64.6 cm2 [26.2, 103.1], p = 0.001; I2: 0%). There was no significant difference in terms of SFA between patients with severe and non-severe COVID-19 (mean difference 9.3 cm2 [-4.9, 23.4], p = 0.199; I2: 1.2%). Pooled ORs showed that VTA was associated with severe COVID-19 (OR 1.9 [1.1, 2.2], p = 0.002; I2: 49.3%). Conclusion: Visceral adiposity was associated with increased COVID-19 severity, while subcutaneous adiposity was not. Prospero id: CRD42020215876.
KW - Adiposity
KW - Coronavirus
KW - Obesity
KW - Visceral fat
KW - Visceral fat area
UR - http://www.scopus.com/inward/record.url?scp=85104309308&partnerID=8YFLogxK
U2 - 10.1016/j.clnesp.2021.04.001
DO - 10.1016/j.clnesp.2021.04.001
M3 - Article
AN - SCOPUS:85104309308
SN - 2405-4577
VL - 43
SP - 163
EP - 168
JO - Clinical Nutrition ESPEN
JF - Clinical Nutrition ESPEN
ER -