key: cord-0727852-fg1j8s90
authors: Wang, Yadong; Xu, Jie; Wang, Ying; Hou, Hongjie; Feng, Huifen; Yang, Haiyan
title: Obesity and COVID-19 mortality()()
date: 2021-06-29
journal: Metabolism
DOI: 10.1016/j.metabol.2021.154820
sha: 8f29af09a15cf9464513111e95693288151c3a7b
doc_id: 727852
cord_uid: fg1j8s90

nan

used to assess publication bias [13] . Leave-one-out sensitivity analysis was performed to assess the stability of the results [14, 15] . P < 0.05 was considered statistically significant.

The main characteristics of the included studies are summarized in Table 1 . A total of 138 studies with 3,863,516 cases were included. Our results demonstrated COVID-19 patients with obesity had a significantly higher risk for mortality compared to those without obesity (pooled effect size = 1.29, 95% CI: 1.24-1.35; Figure 1A ). Sensitivity analysis revealed our results were stable ( Figure 1B ).

Consistent findings were observed in the subgroup analyses by sample size, age, male percentage and setting. Begg's test indicated there was no potential publication bias (P = 0.331).

Several limitations existed in this meta-analysis. First, most of the included studies were from Americas and Europe, thus the findings should be explained with caution in other regions (such as Asia and Africa). Second, although the pooled effect size was estimated on the basis of adjusted effect sizes, the adjusted factors are not fully consistent among the included studies. Third, most of the enrolled studies are retrospective studies, thus further meta-analysis with more prospective studies should be performed to verify our results.

In conclusion, this updated meta-analysis demonstrated obesity was significantly associated with an increased risk for COVID-19 mortality. We hope the updated findings will contribute to more accurate elaboration and substantiation of the data reported by Huang et al [1] . 

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 Figure 1