The Effect of Obesity on the Severity of COVID-19: A Meta-Analysis


  • Okky Nurlita Sari Masters Program in Public Health, Universitas Sebelas Maret
  • Bhisma Murti Masters Program in Public Health, Universitas Sebelas Maret
  • Ignatius Loyola Sukamto Masters Program in Public Health, Universitas Sebelas Maret


Background: Coronavirus Disease 2019 (COVID-19) is an infectious disease of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which first appeared at the end of 2019 in the city of Wuhan, China. Obesity is one of the comorbidities that increases the risk of COVID-19 severity. This study aims to estimate the magnitude of the effect of obesity on the risk of COVID-19 severity based on similar previous primary studies.

Subjects and Method: This research is a systematic review and meta-analysis conducted by following the PRISMA flow diagram. The process of searching for articles through Google Scholar, PubMed and ScienceDirect journal databases by selecting articles published from 2020 to 2021. The keywords used include:


Biscarini S, colaneri M, Ludovisi S, Seminari E, Pieri TC, Valsecchi P, Gallazzi I et al. (2020). The obesity paradox: Analisys from the SMAtteo COVID-19 Regestry (SMACORE) cohort. J Nutr Metab Cardiovasc Dis. 30(11): 1920-1925. DOI: 10.1016/j.numecd.07.047.

Caci G, Albini A, Malerba M, Noonan D, Pochetti P, Polosa R (2020). COVID-19 and obesity: dangerous liaisons. J Clin Med. 9(8):1-12. DOI: 10.3390/jcm.9082511.

Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, He Q, Wang Z, Liu Y et al. (2020). Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China. J. Diabetes Care. 23(7): 1392-1398. DOI: 10.2337/dc20-0576.

CASP (2018). Critical appraisal skills pro-gramme cohort study checklist. Accessed in October 3, 2021.

Caussy C, Wallet F, Laville M, Disse E (2020). Obesity is Associated with Severe Forms of COVID-19. J. Obesity. (28)7: 1175. DOI: 10.1002/oby.22842.

Dong Y, Mo X, Hu Y (2020). Epidemiology of Covid-19 Among Children in China. J. Pediatrics. 145(6). DOI: 10.15-42/peds.2020-0702.

Ebinger JE, Achamallah N, Ji H, Claggett BL, Sun N, Botting P, et al. (2020) Pre-existing traits associated with Covid-19 illness severity. PLoS ONE 15(7): e0236240. DOI: 10.1371/journal.pone.0236240.


Gattinoni L, Chiumello D, Rossi S (2020). COVID-19 pneumonia: ARDS or not? Crit Care. 24(1): 1-3. DOI: 10.1186/s13054-020-02880-z.

Gibson PG, Qin L, Puah SH (2020). COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 213(2): 54-56. DOI: 10.5694/mja2.50674.

Grippo F, Navarra S, Orsi C, Manno V, Grande E, Crialesi R, Frova L, Marchetti S et al. (2020). The role of COVID-19 in the death of sars-COV-2

Hajifathalian K, Kumar S, Newberry C, Shah S, Fortune B, Krisko T et al. (2020). Obesity is Associated with Worse Outcomes in COVID-19: Analysis of Early Data from New York City. J Obesity. 28: 1606-1612. DOI: 10.1002/oby.22923.

Huang C, Wang Y, Li X., Ren L, Zhao J, Hu Y, Zhang L, et al. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 395(10223): 497-506. DOI: 10.1016/S0140-6736(20)30183-5.

Jayanama K, Srichatrapimuk S, Thammavaranucupt K, Kirdlarp S, Suppadungsuk S, Wongsinin T, et al. (2021) The association between body mass index and severity of Coronavirus Di-sease 2019 (COVID-19): A cohort study. PLoS ONE 16(2): e0247023. DOI: 10.1371/journal.pone.0247023.

Jeong IK, Yoon KH, Lee MK (2020). Diabetes and COVID-19: Global and regional perspectives. J. diabetes Res Clin Pract. 166.108303. DOI: 10.1016/j.diabres.2020.108303.

Li R, Liu H, Qi H, et al (2020). Lung ultrasound assessment of acute respiretory distress syndrome caused by coronavirus disease 2019: An observational study. Hong Kong J Emerg Med. DOI: 10.1177/10249079209693-26.

Mikolajewicz N, Komarova SV (2019). Metaanalytic methodology for basic research: A practical guide. Fron Physiol. 10(5). DOI: 10.3389/fphys.2019.-00203.

Nile SH, Nile A, Qiu J, Li L, Jia X, Kai G (2020). COVID-19: Pathogenesis, cytokine storm and therapeutic potential of interferons. Cytokine Growth Factor Rev. 53: 66-70. DOI: 10.1016/j.cytogfr.2020.05.002.

Palaiodimosa L, Kokkinidis DG, Li W, Karamanis D, Ognibeneb J, et al. (2020). Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. J Metabolism

: 154262. DOI: 10.10-16/j.metabol.2020.154262.

Pranata R, Lim MA, Yonas E, Vania R, Lukito AA, Siswanto BB, et al. (2020). Body mass index and outcome in patients with COVID-19: A dose-response meta-analysis. J. diabret 47(2):101178. DOI: 10.1016/j.diabet.2020.07.005.Shang Y, Pan C, Yang X, et al. (2020). Management of critically ill patients with COVID-19 in ICU: statement from frontline intensive care experts in Wuhan, China. Ann Intensive Care. 10(1): 1-24. DOI: 10.1186/s13613-020-00689-1.

Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, et al (2020). High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. J Obesity (Silver Spring). 28(7):1195-1199. DOI: 10.1002/oby.22831.

Suresh S, Siddiqui M, Abu GM, Jou J Simmer S, Mendiratta V, Russel S, Al-Shammari M et al. (2021) Association of obesity with illness severity in hospitalized patients with COVID-19: A retrospective cohort study. J Obes Res Clin Pract. 15(2): 172-176. DOI: 10.1016/J.ORCP.2021.02.006.

Tay MZ, Poh CM, Renia L, MacAry PA, Lisa (2020). The trinity of COVID-19: immunity, inflammation and intervention. Nat Rev Immunol. 20(6): 363-374. DOI: 10.1038/s41577-020-0311-8.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 323(11):1061-1069. DOI: 10.1001/jama.2020.1585

WHO (2021). Coronavirus Disease (COVID-19). World Health Organization. Accessed in October 1, 2021. WHO (2021). Obesity. World Health Organization., Accessed in October 1, 2021.

Ye Q, Wang B, Mao J (2020). The pathogenesis and treatment of the

Yoshida Y, Gillet SA, Brown MI, Zu Y, Wilson S et al. (2021). Clinical characteristics and outcomes in women and men hospitalized for coronavirus disease 2019 in New Orleans. Biol Sex Differ. 12:20 DOI: 10.1186/s13293-02-1-00359-2.

Zheng KI, Gao F, Wang XB, et al. (2020) Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease. Metabolism, 108: 154244. DOI: 10.1016/j.metabol.2020.154244.




How to Cite

Sari, O. N., Murti, B., & Sukamto, I. L. (2021). The Effect of Obesity on the Severity of COVID-19: A Meta-Analysis. Journal of Epidemiology and Public Health, 6(4), 450–458. Retrieved from




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