Visceral adiposity elevates the risk of critical condition in COVID‐19: A systematic review and meta‐analysis

Földi, Mária; Farkas, Nelli; Kiss, Szabolcs; Dembrovszky, Fanni; Szakács, Zsolt; Balaskó, Márta; Erőss, Bálint; Hegyi, Péter; Szentesi, Andrea

OBJECTIVE: A higher body mass index (BMI) has become acknowledged as one of the important risk factors for developing critical condition in coronavirus disease 2019 (COVID‐19). In addition to BMI, body composition, particularly visceral adiposity, might be an even more accurate measure to stratify patients. Therefore, we aimed to evaluate the association between the distributions of CT‐quantified fat mass and critical condition of patients with COVID‐19. METHODS: A systematic search was conducted in five databases for studies published until 17(th) November 2020. In the meta‐analysis, we calculated pooled mean difference (standardized mean difference; SMD) of visceral fat area (VFA; cm(2)) between patients in intensive care unit (ICU) and general ward, and between patients with and without IMV requirement. RESULTS: Our quantitative synthesis revealed that patients requiring intensive care had higher VFA values (SMD=0.46, 95% CI: 0.20, 0.71, p<0.001) compared to patients on the general ward. Similarly, patients requiring IMV had higher VFA values (SMD=0.38, 95% CI: 0.05, 0.71, p=0.026) compared to patients without IMV requirement. CONCLUSIONS: We found that VFA values were significantly higher in patients with critical condition. Therefore, abdominal adiposity seems to be a risk factor in COVID‐19, and patients with central obesity might need special attention.