SynthesisBMC medicine2014
Obesity survival paradox in pneumonia: a meta-analysis.
Synthesis in BMC medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
109 citing papers in PubMed, 6 syntheses or guidelines pooled it, 219 citations in OpenAlex.
- The impact of behavioural risk factors on communicable diseases: a systematic review of reviews.BMC public health · 2021Pooled it
- A systematic review and meta-analysis of obesity and COVID-19 outcomes.Scientific reports · 2021Pooled it
- Temporal Associations Among Body Mass Index, Fasting Insulin, and Systemic Inflammation: A Systematic Review and Meta-analysis.JAMA network open · 2021Pooled it
- Prevalence of Obesity and Its Impact on Outcome in Patients With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in endocrinology · 2021Pooled it
- Obesity and Mortality Among Patients Diagnosed With COVID-19: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Obesity is associated with increased severity of disease in COVID-19 pneumonia: a systematic review and meta-analysis.European journal of medical research · 2020Pooled it
- No obesity paradox in patients with community-acquired pneumonia - secondary analysis of a randomized controlled trial.Nutrition & diabetes · 2022Trial
- Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial.Journal of the American Heart Association · 2017Trial
- Obesity Is Not Associated with Antimicrobial Treatment Failure for Intra-Abdominal Infection.Surgical infections · 2016Trial
- Body Mass Index, Waist Circumference, Readmission, and Healthcare Costs After Influenza- or Pneumonia-Related Hospitalization: A Sex-Stratified Nationwide Cohort Study in Korea.Healthcare (Basel, Switzerland) · 2026Article
- Obesity and respiratory diseases: mechanisms, phenotypes, and clinical implications.Diabetology & metabolic syndrome · 2026Review
- The hospital length of stay and mortality and its risk and protective factors among patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation: a systematic review and meta-analysis.Journal of thoracic disease · 2025Article
- Nonlinear relationship between BMI and 30-day in-hospital mortality in ICU sepsis patients: a multicenter retrospective cohort study.BMC infectious diseases · 2025Article
- Article
- Association between body mass index and the prognosis of community-acquired pneumonia in patients with nontuberculous mycobacterial pulmonary disease: a retrospective cohort study using a nationwide inpatient database.BMC infectious diseases · 2025Article
- Leptin and Acute Lung Disorders.Comprehensive Physiology · 2025Review
- Host and environmental determinants of in-hospital mortality in community-acquired pneumonia: evidence of seasonality, socioeconomic factors, and hospital differentiation in Portugal.BMC pulmonary medicine · 2025Article
- Association of quantified cardiovascular health status with all-cause mortality risk in prediabetic patients.World journal of diabetes · 2025Article
- Association of obesity on short- and long-term survival in patients with moderate to severe pneumonia-related ARDS: a retrospective cohort study.BMC pulmonary medicine · 2025Article
- Lower early mortality and risk prediction improvement of obesity after acute pulmonary embolism: results from a multicenter cohort analysis with external validation.Research and practice in thrombosis and haemostasis · 2025Article
49 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear whether an 'obesity survival paradox' exists for pneumonia. Therefore, we conducted a meta-analysis to assess the associations between increased body mass index (BMI), pneumonia risk, and mortality risk.
methodsCohort studies were identified from the PubMed and Embase databases. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model.
resultsThirteen cohort studies on pneumonia risk (n = 1,536,623), and ten cohort studies on mortality (n = 1,375,482) were included. Overweight and obese individuals were significantly associated with an increased risk of pneumonia (RR = 1.33, 95% CI 1.04 to 1.71, P = 0.02, I(2) = 87%). In the dose-response analysis, the estimated summary RR of pneumonia per 5 kg/m(2) increase in BMI was 1.04 (95% CI 1.01 to 1.07, P = 0.01, I(2) = 84%). Inversely, overweight and obese subjects were significantly associated with reduced risk of pneumonia mortality (RR = 0.83, 95% CI 0.77 to 0.91, P < 0.01, I(2) = 34%). The estimated summary RR of mortality per 5 kg/m(2) increase in BMI was 0.95 (95% CI 0.93 to 0.98, P < 0.01, I(2) = 77%).
conclusionsThis meta-analysis suggests that an 'obesity survival paradox' exists for pneumonia. Because this meta-analysis is based on observational studies, more studies are required to confirm the results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.