scholarly journals Prevalence of Obesity and Its Impact on Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Nafiye Helvaci ◽  
Nesrin Damla Eyupoglu ◽  
Erdem Karabulut ◽  
Bulent Okan Yildiz
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Adverse Outcomes ◽  
Obese Patients ◽  
Obesity Prevalence ◽  
Risk Of Death ◽  
Prevalence Of Obesity ◽  
Obese Subjects ◽  
Polymerase Chain

Background and ObjectiveObesity has been reported as a risk factor for adverse outcomes in COVID-19. However, available studies presenting data on obesity prevalence in patients with COVID-19 have conflicting results. The objective of this systematic review and meta-analysis is to evaluate the prevalence of obesity in these patients and to stratify the estimates by illness severity.MethodsWe performed a literature search with the use of Medline/PubMed and Google Scholar database from December 1, 2019 to June 27, 2020 and systematically reviewed studies reporting the number of obese patients with real-time reverse transcriptase polymerase chain reaction (rRT-PCR)-confirmed SARS-CoV-2 infection.ResultsNineteen studies were identified. The pooled obesity prevalence rates were 0.32 (95% CI: 0.24–0.41) in hospitalized patients, 0.41 (95% CI: 0.36–0.45) in patients admitted to intensive care unit, 0.43 (95% CI: 0.36–0.51) in patients needing invasive mechanic ventilation (IMV), and 0.33 (95% CI: 0.26–0.41) in those who died. Obesity was associated with a higher risk for hospitalization [Odds ratio (OR): 1.3, 95% CI: 1.00–1.69; I2 52%, p = 0.05], ICU admission (OR: 1.51, 95% CI: 1.16–1.97; I2 72%, p = 0.002), and IMV requirement (OR: 1.77, 95% CI: 1.34–2.35; I2 0%, p < 0.001). The increase in risk of death did not reach statistical significance (OR: 1.28, 95% CI: 0.76–2.16, p = 0.35) which might be due to obesity survival paradox and/or unidentified factors.ConclusionsOur data indicate that obese subjects may be at higher risk for serious illness if infected and obesity may play a role in the progression of COVID-19.

scholarly journals The prevalence of obesity in older adults in Iran: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Aliakbar Vaisi-Raygani ◽  
Masoud Mohammadi ◽  
Rostam Jalali ◽  
Akram Ghobadi ◽  
Nader Salari
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Older Adult ◽  
Meta Analysis ◽  
The Body ◽  
Obesity Prevalence ◽  
Analysis Software ◽  
Obesity And Overweight ◽  
Age Dependent ◽  
Prevalence Of Obesity

Abstract Background one of the most important age-dependent physiologic alterations in the body composition of older adult people is obesity and overweight, increasing the risk of cardiovascular disease and mortality rate. Objective The aim of the present study is to determine the prevalence of obesity in older adults in Iran. Methods The present study was conducted via meta-analysis and systematic review method, from March 2000 to October 2018. Subject-related literature was obtained via searches in ScienceDirect, Medline (PubMed), SID, Magiran, Scopus, and Google Scholar databases. Heterogeneity of studies was assessed using the I2 index, and data were analyzed by Comprehensive-Meta analysis software. Results In the assessment of 18 studies and 29,943 persons aged over 50 years, the prevalence of obesity in older adults of Iran was 21.4% (95%CI: 26.6–16.9%) based on the meta-analysis. The highest obesity prevalence was obtained in older adults of Babol (Amir Shahr) which was 44.2% (95%CI: 41.1–47.2%) in 2007, while the minimum obesity prevalence was found in older adults of Razavi Khorasan which was 11.3% (95%CI, 10–12.8%) in 2007. Further, as the sample size and the study year increased, the obesity prevalence diminished in older Iranian adults (p < 0.05). Conclusion This study suggests that the prevalence of obesity in the older adults of Iran is high. Accordingly, healthcare planners and politicians should consider effective and practical policies to reduce obesity in older adults.

Obesity Status and Use of General Surgery Resources

2005 ◽  
Vol 71 (11) ◽  
pp. 963-970
Author(s):  
Kelly R. Finan ◽  
Ruth R. Leeth ◽  
Gilbert Ritchie ◽  
Selwyn M. Vickers ◽  
Mary T. Hawn
Keyword(s):  
General Surgery ◽  
Statistical Significance ◽  
Age Groups ◽  
Female Gender ◽  
Obese Patients ◽  
Obesity Prevalence ◽  
Obesity Status ◽  
Prevalence Of Obesity ◽  
And Gender ◽  
The Impact

Obesity is a rapidly growing epidemic. This study assesses the impact of obesity on surgeon workload for general surgical services. A retrospective study of patients undergoing cholecystectomy, unilateral mastectomy, and colectomy between January 2000 and December 2003 was undertaken. Obesity was defined as body mass index ≥30. The proportion of obese patients was compared to the 2002 BRFSS obesity prevalence data for Alabama. Data were adjusted to control for potential confounders. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. A total of 1,385 patients were included in analysis. The prevalence of obesity in the study population was 35.5 per cent compared to the statewide prevalence of 25.2 per cent (OR = 1.73, 95% CI = 1.51, 1.98). These data were stratified by procedure, age, and gender. The cholecystectomy group had a significantly higher proportion of obese for all age groups and female gender. The mastectomy group had a higher proportion of obese in the 45–64 age group. The stratified colectomy group did not reach statistical significance. There was no evidence of referral bias to explain these findings. This study demonstrates there is a greater use of general surgery services, particularly cholecystectomy and mastectomy, in obese patients than predicted by the prevalence of obesity in the population.

scholarly journals Obesity paradox in patients with cancer: A systematic review and meta-analysis of 6,320,365 patients

2020 ◽  
Author(s):  
Fausto Petrelli ◽  
Alessio Cortellini ◽  
Alice Indini ◽  
Gianluca Tomasello ◽  
Michele Ghidini ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Renal Cell Carcinoma ◽  
Meta Analysis ◽  
Obesity Paradox ◽  
Obese Patients ◽  
Patients With Cancer ◽  
Risk Of Death ◽  
Increased Risk ◽  
Obesity And Cancer

AbstractBACKGROUNDObesity, defined as a body mass index (BMI) > 30 kg/m2, is associated with a significant increase in risk of many cancers. In last years, various studies suggested that obese cancer patients have better outcomes than non-obese patients. This phenomenon, also known as “the obesity paradox”, is not well understood and presents controversial explanations. We performed a systematic review and meta-analysis to assess the association between obesity and outcome after a diagnosis of cancer.PATIENTS AND METHODSPubMed, the Cochrane Library, and EMBASE were searched from inception to January 2020, for studies reporting prognosis of patients with obesity and cancer. Risk of death, cancer-specific survival (CSS) and progression were pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI). The primary outcome of the study refers to overall survival (OS) in obese vs non-obese patients with malignancies. Secondary endpoints were CSS and progression- or disease-free survival (PFS or RFS).RESULTSMortality and relapse associated with obesity in patients with cancer were evaluated among n=6,320,365 participants (n=203 studies). Overall, association of obesity and cancer was associated with a reduced OS (HR =1.14, 95% CI: 1.09-1.19; P<.01) and CSS (HR=1.17, 95%CI 1.12-1.23; P<.01). Patients were also at increased risk for relapse (HR=1.13, 95%CI 1.07-1.19; P<.01). Patients with breast, colorectal and uterine tumors were at increased risk of death. Conversely, obese with lung cancer, renal cell carcinoma and melanoma survived longer that non-obese.CONCLUSIONSIn many cancer patients, obesity reduces survival and increases the risk of relapse. In lung cancer, renal cell carcinoma and melanoma obesity was protective in terms of outcome. More intensive follow up, adequate dosing of oncological treatments, calories intake restrictions, physical activity and monitoring of obesity-related complications are effective measures for reducing mortality in these subjects.

scholarly journals Hydroxychloroquine in the treatment of COVID-19 disease: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Amahirany Manzo-Toledo ◽  
Rafael Torres-Rosas ◽  
Hugo Mendieta-Zerón ◽  
Lourdes Arriaga-Pizano ◽  
Liliana Argueta-Figueroa
Keyword(s):  
Systematic Review ◽  
Quality Evaluation ◽  
Meta Analysis ◽  
Specific Treatment ◽  
Risk Of Bias ◽  
Limited Data ◽  
Bias Assessment ◽  
Risk Of Death ◽  
Polymerase Chain

BACKGROUND Given the urgency of finding a specific treatment for coronavirus disease 2019 (COVID-19), several approaches have been carried out, including the use of chloroquine (CQ) and hydroxychloroquine (HCQ). This study was aimed to systematically evaluate the available evidence on the effectiveness of HCQ in the treatment of COVID-19 disease. METHODS We searched 3 databases (PubMed, Google Scholar, and ClinicalTrials) until May 31, 2020 for clinical studies in patients diagnosed with COVID-19 comparing conventional treatment with and without HCQ combined with or without azithromycin. The risk of bias assessment and quality evaluation was carried out according to the Cochrane recommendations. RESULTS 5 articles (1 randomized clinical trial [RCT], 1 non-RCT, and 3 cohort studies) were included. The main outcome measure in 2 articles was the virological conversion determined by reverse transcription-polymerase chain reaction; however, the findings of both studies were contrary. The main objective of the other studies was to determine the effects of HCQ on COVID-19 mortality, and the studies showed similar results. In general, the studies showed methodological limitations, risk of bias, and variable quality. A meta-analysis from 2,041 patients showed the odds ratio of mortality for patients having HCQ and standard care was 1.38 (95% CI 0.93–2.04). CONCLUSIONS Considering the limited data available and the very low-to-moderate quality of the studies included in this systematic review, the evidence suggests that the HCQ administration does not decrease the risk of death from COVID-19.

scholarly journals Time trends in socio-economic, urban-rural and regional disparities in prevalence of obesity among non-pregnant women in Lesotho: evidence from Lesotho demographic and health surveys (2004–2014)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Gebretsadik Shibre ◽  
Gashaw Garedew Woldeamanuel
Keyword(s):  
Pregnant Women ◽  
Health Surveys ◽  
Educational Inequality ◽  
Statistical Significance ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Obesity Prevalence ◽  
Urban Rural ◽  
Prevalence Of Obesity ◽  
Health Organization

Abstract Background The growing rates of obesity in developing countries are alarming. There is a paucity of evidence about disparities of obesity in Lesotho. This study examined socioeconomic and area-based inequalities in obesity among non-pregnant women in Lesotho. Methods Data were extracted from the 2004, 2009 and 2014 Lesotho Demographic and Health Surveys (LDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. Obesity prevalence was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, simple and complex as well as relative and absolute summary measures were calculated. A 95% confidence interval was used to measure statistical significance of findings. Results We noticed substantial wealth-driven (D = -21.10, 95% CI; − 25.94, − 16.26), subnational region (PAR = -11.82, 95%CI; − 16.09, − 7.55) and urban-rural (− 9.82, 95% CI; − 13.65, − 5.99) inequalities in obesity prevalence without the inequalities improved over time in all the studied years. However, we did not identify educational inequality in obesity. Conclusions Wealth-driven and geographical inequalities was identified in Lesotho in all the studied time periods while education related inequalities did not appear during the same time period. All population groups in the country need to be reached with interventions to reduce the burden of obesity in the country.

scholarly journals Pre-Procedural Lumbar Neuraxial Ultrasound—A Systematic Review of Randomized Controlled Trials and Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 479
Author(s):  
Tatiana Sidiropoulou ◽  
Kalliopi Christodoulaki ◽  
Charalampos Siristatidis
Keyword(s):  
Systematic Review ◽  
Lumbar Spine ◽  
Randomized Controlled Trials ◽  
Success Rate ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Technical Failure ◽  
Obese Patients ◽  
Randomized Controlled ◽  
Meta Analyses

A pre-procedural ultrasound of the lumbar spine is frequently used to facilitate neuraxial procedures. The aim of this review is to examine the evidence sustaining the utilization of pre-procedural neuraxial ultrasound compared to conventional methods. We perform a systematic review of randomized controlled trials with meta-analyses. We search the electronic databases Medline, Cochrane Central, Science Direct and Scopus up to 1 June 2019. We include trials comparing a pre-procedural lumbar spine ultrasound to a non-ultrasound-assisted method. The primary endpoints are technical failure rate, first-attempt success rate, number of needle redirections and procedure time. We retrieve 32 trials (3439 patients) comparing pre-procedural lumbar ultrasounds to palpations for neuraxial procedures in various clinical settings. Pre-procedural ultrasounds decrease the overall risk of technical failure (Risk Ratio (RR) 0.69 (99% CI, 0.43 to 1.10), p = 0.04) but not in obese and difficult spinal patients (RR 0.53, p = 0.06) and increase the first-attempt success rate (RR 1.5 (99% CI, 1.22 to 1.86), p < 0.0001, NNT = 5). In difficult spines and obese patients, the RR is 1.84 (99% CI, 1.44 to 2.3; p < 0.0001, NNT = 3). The number of needle redirections is lower with pre-procedural ultrasounds (SMD = −0.55 (99% CI, −0.81 to −0.29), p < 0.0001), as is the case in difficult spines and obese patients (SMD = −0.85 (99% CI, −1.08 to −0.61), p < 0.0001). No differences are observed in procedural times. Ιn conclusion, a pre-procedural ultrasound provides significant benefit in terms of technical failure, number of needle redirections and first attempt-success rate. Τhe effect of pre-procedural ultrasound scanning of the lumbar spine is more significant in a subgroup analysis of difficult spines and obese patients.

A systematic review and meta-analysis on endovascular treatment as an attractive alternative for acute superior mesenteric venous thrombosis

Vascular ◽  
2021 ◽  
pp. 170853812199127
Author(s):  
Lixin Wang ◽  
Enci Wang ◽  
Fei Liu ◽  
Wei Zhang ◽  
Xiaolong Shu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Venous Thrombosis ◽  
Endovascular Treatment ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Published Data ◽  
Mesenteric Venous Thrombosis ◽  
Surgery Group

Objective This systematic review and meta-analysis evaluated the published data on the efficacy and safety of therapies for superior mesenteric venous thrombosis (SMVT), aiming to provide a reference and set of recommendations for clinical treatment. Methods Relevant databases were searched for studies published from 2000 to June 2020 on SMVT treated with conservative treatment, surgical treatment, or endovascular approach. Different treatment types were grouped for analysis and comparison, and odds ratios with corresponding 95% confidence intervals were calculated. The outcomes were pooled using meta-analytic methods and presented by forest plots. Results Eighteen articles, including eight on SMVT patients treated with endovascular therapies, were enrolled. The treatment effectiveness was compared between different groups according to the change of symptoms, the occurrence of complications, and mortality as well. The conservative treatment group had better efficacy compared to the surgery group (89.0% vs. 78.6%, P <0.05), and the one-year survival rate was also higher (94.4% vs. 80.0%, P >0.05), but without statistical significance. As for endovascular treatment, the effectiveness was significantly higher than the surgery group (94.8% vs. 75.2%, P <0.05), and the conservative treatment group as well (93.3% vs. 86.3%, P >0.05), which still requires further research for the lack of statistical significance. Conclusions Present findings indicate that anticoagulation, as conservative treatment should be the preferred clinical option in the clinic for SMVT, due to its better curative effect compared to other treatment options, including lower mortality, fewer complications, and better prognosis. Moreover, endovascular treatment is a feasible and promising approach that is worth in-depth research, for it is less invasive than surgery and has relatively better effectiveness, thus can provide an alternative option for SMVT treatment and may be considered as a reliable method in clinical.

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