SynthesisDiabetes care2021
Diabetes and Overweight/Obesity Are Independent, Nonadditive Risk Factors for In-Hospital Severity of COVID-19: An International, Multicenter Retrospective Meta-analysis.
Synthesis in Diabetes care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 4 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Sleep disturbance increases the risk of severity and acquisition of COVID-19: a systematic review and meta-analysis.European journal of medical research · 2023Pooled it
- Risk phenotypes of diabetes and association with COVID-19 severity and death: an update of a living systematic review and meta-analysis.Diabetologia · 2023Pooled it
- Comorbidities and complications of COVID-19 associated with disease severity, progression, and mortality in China with centralized isolation and hospitalization: A systematic review and meta-analysis.Frontiers in public health · 2022Pooled it
- COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship.Obesity research & clinical practicePooled it
- Efficacy of Niclosamide vs Placebo in SARS-CoV-2 Respiratory Viral Clearance, Viral Shedding, and Duration of Symptoms Among Patients With Mild to Moderate COVID-19: A Phase 2 Randomized Clinical Trial.JAMA network open · 2022Trial
- Accelerated vascular ageing after COVID-19 infection: the CARTESIAN study.European heart journal · 2025Observational
- Factors affecting COVID-19 outcomes in Ireland: findings from a national database of 1,408,249 cases diagnosed between 2020 and 2022.BMC public health · 2025Article
- Molecular dissection of the role of ACE2 in glucose homeostasis.Physiological reviews · 2025Review
- Measurement of serum 1,5-AG provides insights for diabetes management and the anti-viral immune response.Cellular and molecular life sciences : CMLS · 2025Article
- Severity of SARS-CoV-2 Illness in Patients With Type 1 and Type 2 Diabetes Mellitus.HCA healthcare journal of medicine · 2025Article
- High glycemic variability is associated with a reduced T cell cytokine response to influenza A virus.iScience · 2024Article
- Observational
- Immune Stimulation with Imiquimod to Best Face SARS-CoV-2 Infection and Prevent Long COVID.International journal of molecular sciences · 2024Review
- Article
- Retrospective study of the impact of diabetes on the severity and prognosis of COVID‑19.Experimental and therapeutic medicine · 2024Article
- Identification of distinct phenotypes and improving prognosis using metabolic biomarkers in COVID-19 patients.Critical care science · 2024Article
- Effects of COVID-19 on diabetes care among dutch diabetes outpatients.Diabetology & metabolic syndrome · 2023Article
- Severity of SARS-CoV-2 infection in a hospital population: a clinical comparison across age groups.Italian journal of pediatrics · 2023Article
- Changes in Food Consumption, BMI, and Body Composition in Youth in the US during the COVID-19 Pandemic.International journal of environmental research and public health · 2023Article
- Metabolic Associated Fatty Liver Disease (MAFLD) and COVID-19 Infection: An Independent Predictor of Poor Disease Outcome?Medicina (Kaunas, Lithuania) · 2023Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveObesity is an established risk factor for severe coronavirus disease 2019 (COVID-19), but the contribution of overweight and/or diabetes remains unclear. In a multicenter, international study, we investigated if overweight, obesity, and diabetes were independently associated with COVID-19 severity and whether the BMI-associated risk was increased among those with diabetes. RESEARCH DESIGN AND
methodsWe retrospectively extracted data from health care records and regional databases of hospitalized adult patients with COVID-19 from 18 sites in 11 countries. We used standardized definitions and analyses to generate site-specific estimates, modeling the odds of each outcome (supplemental oxygen/noninvasive ventilatory support, invasive mechanical ventilatory support, and in-hospital mortality) by BMI category (reference, overweight, obese), adjusting for age, sex, and prespecified comorbidities. Subgroup analysis was performed on patients with preexisting diabetes. Site-specific estimates were combined in a meta-analysis.
resultsAmong 7,244 patients (65.6% overweight/obese), those with overweight were more likely to require oxygen/noninvasive ventilatory support (random effects adjusted odds ratio [aOR], 1.44; 95% CI 1.15-1.80) and invasive mechanical ventilatory support (aOR, 1.22; 95% CI 1.03-1.46). There was no association between overweight and in-hospital mortality (aOR, 0.88; 95% CI 0.74-1.04). Similar effects were observed in patients with obesity or diabetes. In the subgroup analysis, the aOR for any outcome was not additionally increased in those with diabetes and overweight or obesity.
conclusionsIn adults hospitalized with COVID-19, overweight, obesity, and diabetes were associated with increased odds of requiring respiratory support but were not associated with death. In patients with diabetes, the odds of severe COVID-19 were not increased above the BMI-associated risk.
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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.