The COVID-19 pandemic has posed many challenges over the last three years, and significant research has been done regarding its health effects and factors contributing to positive or negative patient outcomes. Among others, obesity and high body mass index (BMI) have been identified as major aggravating factors in COVID-19 patients. This was mainly explained by the fact that in many cases, obesity is associated with other co-existing conditions that can lead to extremely dangerous consequences. Multiple studies have been done that identified this connection, suggesting possible strategies to minimize its negative effects. A 2021 study conducted by Sjögren, et al. addressed this issue, attempting to analyze the impact of obesity in COVID-19 intensive care units (ICUs) patients in Swedish Intensive Care Registry. Another 2021 study on this topic was conducted by Cai, et al. and aimed to evaluate the degree to which “obesity is associated with severe disease and mortality in patients with coronavirus disease” (Cai, et al. 1). Therefore, recent research suggests that obesity and high BMI have a negative impact on the COVID-19 patients’ health outcomes and are associated with increased mortality rates.
The study by Sjögren, et al. used previous research as a basis for presenting and confirming the authors’ hypothesis, which is that coronavirus-related deaths and prolonged length of stay (LOS) are affected by patients’ high BMI. The authors applied observational research as the main technique to assess patient outcomes. Data was collected using “the Swedish Intensive Care Registry (SIR), medical records and the Swedish Passport Register on patients with COVID-19 admitted to ICUs in Sweden during the first wave of the COVID-19 pandemic” (Sjögren, et al. 2). The information retrieved from the Registry mostly concerned the diagnoses, treatments, interventions, and inpatient care from the ICUs in Swedish hospitals. The mean age of the study cohort was 60.1 years, and 74% of the patients observed were male (Sjögren, et al. 5). The results of the study have demonstrated that high BMI increased patients’ risks of death due to complications resulting from other obesity-related co-existing conditions, such as low immunological protection, blood clotting disorders, and chronic inflammations (Sjögren, et al). In addition, a significant number of overweight patients also had a longer-than-average LOS when compared to the reference groups involved in the study.
The study conducted by Cai, et al. aimed to investigate the relationship between excess weight, the severity, and the incidence of COVID-19 cases, raising public awareness about the impact of obesity on patients’ health outcomes. The researchers used meta-analysis based on the literature search as the main method. Academic databases such as “PubMed, EMBASE, the Cochrane Library and Web of Science” were used to review articles on “the mortality due to and severity of COVID-19” (Cai, et al. 2). The inclusion criteria for the literature search included patients with a confirmed diagnosis of COVID-19, the availability of BMI values, as well as the comorbidities and severity of the disease (Cai, et al.). In turn, “the exclusion criteria were as follows: case reports, reviews, letters or nonhuman studies, studies written in a language other than English, and studies with insufficient information” (Cai, et al. 2). According to the findings of this study, the articles analyzed showed that obesity increased the risk of viral infections, hospitalization, severe disease, mortality, and ICU admission. Therefore, the study considered obesity to be a major predictor of severe health consequences in COVID-19 patients.
There are many similarities that can be found between the two articles summarized above. First, the purpose of both of them was to determine if there is a direct connection between high BMI and the severity of health outcomes in the cases of a new coronavirus infection. The studies were published in approximately the same time period. Most importantly, the studies did find a strong relation between obesity and severe health outcomes, identifying several areas and effects that were mostly observed in overweight COVID-19 patients. These included impaired immune function, low total lung capacity, increased risk of hospitalization, and death (Cai, et al.; Sjögren, et al.). Another similarity is the fact that the two studies relied heavily upon the previous research on clinical presentations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In addition, both studies identified coexisting conditions that were common in patients suffering from obesity and also increased the risk of severe post-acute COVID-19 outcomes. Among others, these included hypertension, dyslipidemia, and type 2 diabetes (Cai, et al.; Sjögren, et al.). Finally, both articles suggested that obese patients have to be monitored more closely in COVID-19 hospital units.
Despite the many similarities found between the articles by Cai, et al. and Sjögren, et al., there are several aspects that distinguish them. For example, the study by Sjögren, et al. was a cohort study that focused on patients in Swedish intensive care units. Therefore, it may have limitations in terms of the universal application of its findings on the global scale. In turn, the study by Cai, et al. was a literature search that analyzed related articles published by scholars around the world. However, it should be noted that Cai, et al. have excluded “studies written in a language other than English” from their selection (2). Another difference lies in the data collection methods used by the researchers. Thus, Sjögren, et al. used observations and a register-based approach to gather data for the study, while Cai, et al. used records and documents to collect evidence that confirm the suggested hypothesis. Moreover, the first study can be defined as a statistical analysis that used descriptive characteristics as its main variables. Meanwhile, the second study is a meta-analysis that combined, investigated, and validated the findings of multiple other scientific works.
It can be concluded that the two articles analyzed above have provided an extensive overview on the issue of obesity in relation to the negative outcomes in COVID-19 patients. The findings of both articles confirm that there is a strong relation between high BMI and severe health effects resulting from COVID-19. Thus, Sjögren, et al. have evaluated the patients’ risk of death and possible prolonged LOS and found that there is a significant likelihood for these outcomes being caused by obesity. Cai, et al. have found that the connection between severe COVID-19 outcomes and high BMI account for the increased risk of viral infection, admission to the ICUs, hospitalization, severe disease, and mortality. There are several aspects of the issue in question that can be addressed in further studies. First, additional attention may be paid to different risk indicators, such as viral infection and ICU admissions, to provide scholars with an opportunity to conduct subgroup analyses for each factor. In addition, future studies can be recommended to include specific BMI values to be able to assess the degree to which certain units’ increases in BMI enhance COVID-19 severity and mortality rate.
Works Cited
Cai, Zixin, et al. “Obesity is associated with severe disease and mortality in patients with coronavirus disease 2019 (COVID-19): a meta-analysis.” BMC Public Health, vol. 21, no. 1, 2021, pp. 1-14.
Sjögren, Lovisa, et al. “Impact of obesity on intensive care outcomes in patients with COVID-19 in Sweden—A cohort study.” PLOS ONE, vol. 16, no. 10, 2021, p. e0257891.