The effect of obesity on the mortality of hospitalized adults with COVID‐19 considering the human development index: A systematic review and meta‐analysis

Summary The objective of this study is to verify the association between obesity and mortality in hospitalized patients with SARS–CoV–2 taking into account the Human Development Index (HDI). A search was performed in the PubMed, Virtual Health Library (Lilacs/Bireme/VHL Brazil), Embase, Web of Science, and Scopus databases from inception to May 2022. To be eligible, studies had to have cohort or case–control designs, be conducted with hospitalized adults (≥18 years old), and evaluate mortality rates between with obesity and without obesity individuals with SARS‐CoV‐2 confirmed by laboratory tests. The analyses were performed in Stata 12.0 using relative risk (RR) as a summary measure. Heterogeneity was explored by meta‐regression and subgroup analyses considering the HDI, age, sex, and follow‐up period. Out of 912 studies screened, 49 studies were eligible for qualitative synthesis, and 33 studies were eligible for quantitative analysis, representing 42,905 patients. The mortality risk from SARS‐CoV‐2 was higher in individuals with obesity compared with without obesity individuals only in the subgroups of patients <60 years old (RR = 1.31; 95% CI 1.18–1.45, I 2 = 0.0%) and living in countries with a low HDI (RR = 1.28; 95% CI 1.10–1.48, I 2 = 45.4%).