Letter to the Editor: obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease
Open accessThe claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Aging, obesity and inflammation-related diseases such as diabetes and cardiovascular diseases are risk factors for the severity of COVID-19.
“Of note, aging, obesity and inflammation-related diseases such as diabetes and cardiovascular diseases have been shown to be risk factors for the severity of COVID-19 (293, 371–373).”
From IL-6 in inflammation, autoimmunity and cancer (2021) · cites this paper as [371]
The letter’s Table 2 and accompanying text report that obesity was associated with greater COVID-19 severity in patients with MAFLD, even after adjustment for age and diabetes (page not specified in our copy). They do not establish aging, diabetes, or cardiovascular disease as independent risk factors; the broader population claim also exceeds the study’s MAFLD cohort. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30183-5 · Cited by 48,884 · cited 1× · see citing works
“Systemic inflammatory response syndrome, a common complication in severe COVID-19 [12], is promoted by the activation of CD14+ and”
Clinical characteristics of coronavirus disease 2019 in China
Guan, W.-J., Ni, Z.-Y., Hu, Y., Liang, W.-H., Ou, C.-Q., He, J.-X., Liu, L., Shan, H., Lei, C.-L., Hui, D. S. C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2002032 · Cited by 30,246 · cited 1× · see citing works
“Preliminary data suggests that obesity may aggravate the severity of respiratory diseases and of COVID-19 [2].”
Self-citationAlberti, K. G. M. M., Zimmet, P., & Shaw, J. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01858.x · Cited by 6,597 · cited 1× · see citing works
“hypertension and dyslipidemia were diagnosed based on established criteria.[10] All patients denied a history of chronic obstructive or restrictive pulmonary disease.”
BackgroundEslam, M., Newsome, P. N., Sarin, S. K., Anstee, Q. M., Targher, G., Romero-Gomez, M., Zelber-Sagi, S., Wai-Sun Wong, V., Dufour, J.-F., Schattenberg, J. M., et al. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.03.039 · Cited by 4,472 · cited 2× · see citing works
“[2] Patients with metabolic associated fatty liver disease (MAFLD),[3] formerly known as non-alcoholic fatty liver disease, are often obese and have additional metabolic risk factors which may translate to a greater risk from respiratory diseases.”
BackgroundMethodSelf-citationVisceral fat: A key mediator of steatohepatitis in metabolic liver disease
van der Poorten, D. K., Milner, K.-L., Hui, J., Hodge, A., Trenell, M., Kench, J., London, R., Peduto, T., Chisholm, D. J., & George, J. (2008) · Hepatology · doi:10.1002/hep.22350 · Cited by 633 · cited 2× · see citing works
“[13] In MAFLD patients, particularly those with obesity, increased inflammatory activity in the liver and visceral fat is independently correlated with increased levels of IL-6,[14] which might have an additive/synergistic role in promoting greater severity of COVID-19.”
BackgroundSelf-citationCOVID-19 and Liver Dysfunction: Current Insights and Emergent Therapeutic Strategies
Feng, G., Zheng, K. I., Yan, Q., Rios, R. S., Targher, G., Byrne, C. D., Poucke, S. V., Liu, W., & Zheng, M. (2020) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2020.00018 · Cited by 421 · cited 1× · see citing works
“This suggests IL-6 is a key proinflammatory factor that triggers the inflammatory “storm” in patients.[13] In MAFLD patients, particularly those with obesity, increased inflammatory activity in the liver and visceral fat is independently correlated with increased levels of IL-6,[14] which might have an additive/synerg…”
BackgroundSelf-citationObesity Is a Risk Factor for Greater COVID-19 Severity
Gao, F., Zheng, K. I., Wang, X.-B., Sun, Q.-F., Pan, K.-H., Wang, T.-Y., Chen, Y.-P., Targher, G., Byrne, C., George, J., et al. (2020) · Diabetes Care · doi:10.2337/dc20-0682 · Cited by 376 · cited 1× · see citing works
“for severe COVID-19 with a dose-effect relationship between increasing BMI and the proportion of patients with severe illness.[11] In the current analysis, the risk of severe illness in MAFLD patients with co-existing obesity was more than 6-fold greater after adjustment for confounders.”
BackgroundSelf-citationLean NAFLD: A Distinct Entity Shaped by Differential Metabolic Adaptation
Chen, F., Esmaili, S., Rogers, G. B., Bugianesi, E., Petta, S., Marchesini, G., Bayoumi, A., Metwally, M., Azardaryany, M. K., Coulter, S., et al. (2019) · Hepatology · doi:10.1002/hep.30908 · Cited by 330 · see citing works
Self-citationNseir, W., Mograbi, J., Amara, A., Abu-Elheja, O., & Mahamid, M. (2018) · QJM : monthly journal of the Association of Physicians · doi:10.1093/qjmed/hcy227 · Cited by 47 · cited 1× · see citing works
“[4] [5] [6] [7] It is currently not known whether MALFD patients are also more likely to have greater COVID-19 severity of illness.”
Nonalcoholic fatty liver disease is associated with decreased lung function
Lee, C.-H., Choi, S.-H., Chung, G., Park, B., & Kwak, M.-S. (2018) · Liver international (Print) · doi:10.1111/liv.13860 · Cited by 36 · cited 1× · see citing works
“[4] [5] [6] [7] It is currently not known whether MALFD patients are also more likely to have greater COVID-19 severity of illness.”
Obesity and Overweight in Asian People.
Goda, A., & Masuyama, T. (2016) · Circulation Journal · doi:10.1253/circj.cj-16-1087 · Cited by 34 · cited 1× · see citing works
“Obesity was defined as BMI N25 kg/m(2) [9].”
Association Between Pulmonary Function and Nonalcoholic Fatty Liver Disease in the NHANES III Study
Peng, T.-C., Kao, T., Wu, L.-W., Chen, Y.-J., Chang, Y.-W., Wang, C.-C., Tsao, Y.-T., & Chen, W.-L. (2015) · Medicine · doi:10.1097/md.0000000000000907 · Cited by 25 · cited 1× · see citing works
“[2] Patients with metabolic associated fatty liver disease (MAFLD),[3] formerly known as non-alcoholic fatty liver disease, are often obese and have additional metabolic risk factors which may translate to a greater risk from respiratory diseases.[4-7] It is currently not known whether MALFD patients are also more lik…”
BackgroundSelf-citationArias, M., Fábrega, E., López‐Hoyos, M., & Crespo, J. (2015) · BioMed Research International · doi:10.1155/2015/319745 · Cited by 17 · cited 1× · see citing works
“[4] [5] [6] [7] It is currently not known whether MALFD patients are also more likely to have greater COVID-19 severity of illness.”
Flagged first, then by citations
1 of the 14 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [8]National Health Commission & State Administration of Traditional Chinese Medicine Diagnosis and treatment protocol for novel coronavirus pneumonia (trial version 7) 2020 [EB/OL]. 2020.03.03 PMC7227203 40479241
Cited by
Sorted by citations
IL-6 in inflammation, autoimmunity and cancer
Hirano, T. (2021) · International Immunology · doi:10.1093/intimm/dxaa078 · Cited by 1,453 · see citing works
Risk factors for severe and critically ill COVID‐19 patients: A review
Gao, Y., Ding, M., Dong, X., Zhang, J., Azkur, A. K., Azkur, D., Gan, H. K., Sun, Y., Fu, W., Li, W., et al. (2020) · Allergy · doi:10.1111/all.14657 · Cited by 1,399 · see citing works
Popkin, B. M., Du, S., Green, W. D., Beck, M. A., Algaith, T., Herbst, C. H., Alsukait, R. F., Alluhidan, M., Alazemi, N., & Shekar, M. (2020) · Obesity Reviews · doi:10.1111/obr.13128 · Cited by 1,150 · see citing works
Beyerstedt, S., Casaro, E. B., & Rangel, É. B. (2021) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-020-04138-6 · Cited by 897 · see citing works
COVID-19 in people with diabetes: understanding the reasons for worse outcomes
Apicella, M., Campopiano, M. C., Mantuano, M., Mazoni, L., Coppelli, A., & Prato, S. D. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30238-2 · Cited by 905 · see citing works
Palaiodimos, L., Kokkinidis, D. G., Li, W., Karamanis, D., Ognibene, J., Arora, S., Southern, W. N., & Mantzoros, C. (2020) · medRxiv · doi:10.1101/2020.05.05.20091983 · Cited by 671
Obesity in patients with COVID-19: a systematic review and meta-analysis
Huang, Y., Lu, Y., Huang, Y.-M., Wang, M., Ling, W., Sui, Y., & Zhao, H.-L. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154378 · Cited by 454 · see citing works
Louapre, C., Collongues, N., Stankoff, B., Giannesini, C., Papeix, C., Bensa, C., Deschamps, R., Créange, A., Wahab, A., Pelletier, J., et al. (2020) · JAMA Neurology · doi:10.1001/jamaneurol.2020.2581 · Cited by 455 · see citing works
Merzon, E., Tworowski, D., Gorohovski, A., Vinker, S., Golan-Cohen, A., Green, I., & Morgenstern, M. F. (2020) · medRxiv · doi:10.1111/febs.15495 · Cited by 411 · see citing works
de Almeida-Pititto, B., Dualib, P. M., Zajdenverg, L., Dantas, J. R., de Souza, F. D., Rodacki, M., Bertoluci, M. C., & Brazilian Diabetes Society Study Group (SBD) (2020) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-020-00586-4 · Cited by 391 · see citing works
Shi, Q., Zhang, X., Jiang, F., Zhang, X., Hu, N., Bimu, C., Feng, J., Yan, S. Y., Guan, Y., Xu, D., et al. (2020) · Diabetes Care · doi:10.2337/dc20-0598 · Cited by 413 · see citing works
The effect of smoking on COVID‐19 severity: A systematic review and meta‐analysis
Reddy, R. K., Charles, W. N., Sklavounos, A., Dutt, A., Seed, P. T., & Khajuria, A. (2020) · Journal of Medical Virology · doi:10.1002/jmv.26389 · Cited by 466 · see citing works
Obesity and mortality of COVID-19. Meta-analysis
Hussain, A., Mahawar, K., Xia, Z.-F., Yang, W., & El-Hasani, S. (2020) · Obesity Research and Clinical Practice · doi:10.1016/j.orcp.2020.07.002 · Cited by 368 · see citing works
RetractedObesity aggravates COVID‐19: A systematic review and meta‐analysis
Yang, J., Hu, J., & Zhu, C. (2020) · Journal of Medical Virology · doi:10.1002/jmv.26237 · Cited by 410 · see citing works
Sun, D.-Q., Jin, Y., Wang, T.-Y., Zheng, K. I., Rios, R. S., Zhang, H.-Y., Targher, G., Byrne, C., Yuan, W., & Zheng, M. (2020) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2020.154433 · Cited by 294 · see citing works
Self-citationAbnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis
Bertolini, A., van de Peppel, I. P., Bodewes, F. A. J. A., Moshage, H. J., Fantin, A., Farinati, F., Fiorotto, R., Jonker, J. W., Strazzabosco, M., Verkade, H. J., et al. (2020) · Hepatology · doi:10.1002/hep.31480 · Cited by 295 · see citing works
Neutrophils and Neutrophil Extracellular Traps Drive Necroinflammation in COVID-19
Tomar, B., Anders, H., Desai, J., & Mulay, S. R. (2020) · Cells · doi:10.3390/cells9061383 · Cited by 263 · see citing works
Acute Pulmonary Embolism and COVID-19
Poyiadji, N., Cormier, P., Patel, P., Hadied, M., Bhargava, P., Khanna, K., Nadig, J., Keimig, T., Spizarny, D., Reeser, N., et al. (2020) · Radiology · doi:10.1148/radiol.2020201955 · Cited by 228 · see citing works
“Our study, in conjunction with recent and future studies, may prompt early evaluation with pulmonary CT angiography in patients with coronavirus disease 2019 who are at increased risk for developing pulmonary embolism based on demographic, clinical, and laboratory variables (6,7,10).”
BackgroundResultCommentary: Obesity: The “Achilles heel” for COVID-19?
Muscogiuri, G., Pugliese, G., Barrea, L., Savastano, S., & Colao, A. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154251 · Cited by 230 · see citing works
Watanabe, M., Caruso, D., Tuccinardi, D., Risi, R., Zerunian, M., Polici, M., Pucciarelli, F., Tarallo, M., Strigari, L., Manfrini, S., et al. (2020) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2020.154319 · Cited by 195 · see citing works
“Noteworthy, our results are in line with a previous report suggesting that ectopic fat depositionwithin the liver is strongly associated to COVID-19 clinical severity among obese subjects [30].”
Obesity is Associated with Worse Outcomes in COVID‐19: Analysis of Early Data from New York City
Hajifathalian, K., Kumar, S. R., Newberry, C. A., Shah, S. L., Fortune, B. E., Krisko, T. I., Ortiz‐Pujols, S., Zhou, X. K., Dannenberg, A. J., Kumar, R. B., et al. (2020) · Obesity · doi:10.1002/oby.22923 · Cited by 205 · see citing works
Singh, R., Rathore, S. S., Khan, H., Karale, S., Chawla, Y., Iqbal, K., Bhurwal, A., Tekin, A., Jain, N., Mehra, I., et al. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.780872 · Cited by 193 · see citing works
Simons, D., Shahab, L., Brown, J., & Perski, O. (2020) · Qeios · doi:10.32388/ujr2aw · Cited by 10 · see citing works
Petersen, A., Bressem, K. K., Albrecht, J., Thieß, H.-M., Vahldiek, J. L., Hamm, B., Makowski, M. R., Niehues, A., Niehues, S. M., & Adams, L. C. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154317 · Cited by 198 · see citing works
“Apart from overall obesity, body fat distribution is an important risk factor for cardiometabolic outcome [1,2].”
InfluentialSimons, D., Shahab, L., Brown, J., & Perski, O. (2020) · Addiction · doi:10.1111/add.15276 · Cited by 377 · see citing works
Extrapulmonary complications of COVID‐19: A multisystem disease?
Zheng, K. I., Feng, G., Liu, W., Targher, G., Byrne, C. D., & Zheng, M. (2020) · Journal of Medical Virology · doi:10.1002/jmv.26294 · Cited by 185 · see citing works
Self-citationAghili, S. M. M., Ebrahimpur, M., Arjmand, B., Shadman, Z., Sani, M. P., Qorbani, M., Larijani, B. A., & Payab, M. (2021) · International Journal of Obesity · doi:10.1038/s41366-021-00776-8 · Cited by 236 · see citing works
T-Cell Hyperactivation and Paralysis in Severe COVID-19 Infection Revealed by Single-Cell Analysis
Kalfaoglu, B., Almeida‐Santos, J., Tye, C. A., Satou, Y., & Ono, M. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.589380 · Cited by 175 · see citing works
Obesity and COVID-19: what makes obese host so vulnerable?
Mohammad, S., Aziz, R., Mahri, S. A., Malik, S. S., Haji, E. M., Khan, A. H., Khatlani, T., & Bouchama, A. (2021) · Immunity & Ageing · doi:10.1186/s12979-020-00212-x · Cited by 180 · see citing works
“SARS-COV- 2: Severe acute respiratory syndrome coronavirus 2; COVID19: Coronavirus disease; BMI: Body Mass Index; IMV: Intermittent Mandatory Ventilation; ICU: Intensive Care Unit; MAFLD: Metabolic associated fatty liver disease; H1N1: Influenza A virus subtype H1N1; ACE-2: Angiotensinconverting enzyme 2; Th cells: T…”
BackgroundInfluentialShibata, S., Arima, H., Asayama, K., Hoshide, S., Ichihara, A., Ishimitsu, T., Kario, K., Kishi, T., Mogi, M., Nishiyama, A., et al. (2020) · Hypertension Research · doi:10.1038/s41440-020-0515-0 · Cited by 175 · see citing works
“It may also be a determinant of disease severity, independent of age and hypertension [14, 19].”
BackgroundTwo important controversial risk factors in SARS-CoV-2 infection: Obesity and smoking
Engin, A. B., Engin, A., & Engin, A. (2020) · Environmental Toxicology and Pharmacology · doi:10.1016/j.etap.2020.103411 · Cited by 187 · see citing works
Chu, Y., Yang, J., Shi, J., Zhang, P., & Wang, X. (2020) · European journal of medical research · doi:10.1186/s40001-020-00464-9 · Cited by 149 · see citing works
Self-citationSawadogo, W., Tsegaye, M., Gizaw, A., & Adera, T. (2022) · BMJ Nutrition, Prevention & Health · doi:10.1136/bmjnph-2021-000375 · Cited by 133 · see citing works
Rottoli, M., Bernante, P., Belvedere, A., Balsamo, F., Garelli, S., Giannella, M., Cascavilla, A., Tedeschi, S., Ianniruberto, S., Turco, E. R. D., et al. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0541 · Cited by 130 · see citing works
Du, Y., Lv, Y., Zha, W., Zhou, N., & Hong, X.-Q. (2020) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2020.154373 · Cited by 129 · see citing works
“Of these studies, fourwere performed in Asia [24,26,28,34], including China (n=3) and Kuwait (n=1); Nine in America [8,21,23,25,27,31–33,35], including USA (n=7) andMexico (n = 2); and three in Europe [22,29,30], including Italy (n = 2) and France (n=1).”
InfluentialCOVID‐19 and non‐alcoholic fatty liver disease: Two intersecting pandemics
Portincasa, P., Krawczyk, M. J., Smyk, W., Lammert, F., & Ciaula, A. D. (2020) · European Journal of Clinical Investigation · doi:10.1111/eci.13338 · Cited by 141 · see citing works
Scheen, A. J., Marre, M., & Thivolet, C. H. (2020) · Diabetes & Metabolism · doi:10.1016/j.diabet.2020.05.008 · Cited by 142 · see citing works
Cardiac Involvement of COVID-19: A Comprehensive Review
Chang, W., Toh, H. S., Liao, C., & Yu, W. (2020) · The American Journal of the Medical Sciences · doi:10.1016/j.amjms.2020.10.002 · Cited by 162 · see citing works
COVID-19 in pregnant women: A systematic review and meta-analysis
Capobianco, G., Saderi, L., Aliberti, S., Mondoni, M., Piana, A., Dessole, F., Dessole, M., Cherchi, P., Dessole, S., & Sotgiu, G. (2020) · European Journal of Obstetrics, Gynecology, and Reproductive Biology · doi:10.1016/j.ejogrb.2020.07.006 · Cited by 127 · see citing works
Deng, M., Qi, Y.-J., Deng, L.-P., Wang, H.-W., Xu, Y.-C., Li, Z., Meng, Z., Tang, J., & Dai, Z. (2020) · Obesity · doi:10.1002/oby.22943 · Cited by 118 · see citing works
Palaiodimos, L., Kokkinidis, D. G., Li, W., Karamanis, D., Ognibene, J., Arora, S., Southern, W. N., & Mantzoros, C. S. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154262 · Cited by 864 · see citing works
Are we equal in adversity? Does Covid-19 affect women and men differently?
Rozenberg, S., Vandromme, J., & Martin, C. (2020) · Maturitas · doi:10.1016/j.maturitas.2020.05.009 · Cited by 123 · see citing works
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a review
Feng, W., Zong, W., Wang, F., & Ju, S. (2020) · Molecular Cancer · doi:10.1186/s12943-020-01218-1 · Cited by 152 · see citing works
Gao, F., Zheng, K. I., Wang, X.-B., Yan, H., Sun, Q.-F., Pan, K.-H., Wang, T.-Y., Chen, Y.-P., George, J., & Zheng, M. (2020) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.15112 · Cited by 109
Self-citationImpact of obesity on hospitalizations and mortality, due to COVID-19: A systematic review
de Siqueira, J. V. V., Almeida, L. G., Zica, B. O., Brum, I. B., Barceló, A., & Galil, A. G. D. S. (2020) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2020.07.005 · Cited by 120 · see citing works
COVID-19 and Preexisting Comorbidities: Risks, Synergies, and Clinical Outcomes
Bigdelou, B., Sepand, M. R., Najafikhoshnoo, S., Negrete, J. A. T., Sharaf, M., Ho, J. Q., Sullivan, I., Chauhan, P. S., Etter, M. M., Shekarian, T., et al. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.890517 · Cited by 122 · see citing works
COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist
Hunt, R. H., East, J. E., Lanas, Á., Malfertheiner, P., Satsangi, J. J., Scarpignato, C., & Webb, G. J. (2020) · Digestive Diseases · doi:10.1159/000512152 · Cited by 124 · see citing works
Impact of obesity on COVID-19 patients
Yu, W., Rohli, K. E., Yang, S., & Jia, P. (2020) · Journal of diabetes and its complications · doi:10.1016/j.jdiacomp.2020.107817 · Cited by 101 · see citing works
Zawawi, Z. M., Kalyanasundram, J., Zain, R. M., Thayan, R., Basri, D. F., & Yap, W. B. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24076142 · Cited by 99 · see citing works
“Several studies found that obesity was a critical predictor of severe COVID-19 [73].”
BackgroundCai, Z.-X., Yang, Y., & Zhang, J.-J. (2021) · BMC Public Health · doi:10.1186/s12889-021-11546-6 · Cited by 92 · see citing works
Liver injury in COVID-19: clinical features and treatment management
Yu, D., Du, Q., Yan, S., Guo, X., He, Y., Zhu, G., Zhao, K., & Ouyang, S. (2021) · Virology Journal · doi:10.1186/s12985-021-01593-1 · Cited by 97 · see citing works
“Patients with metabolically related fatty liver disease have additional metabolic risk factors, which may be associated with more severe disease phenotype [25].”
BackgroundSriram, K., & Insel, P. A. (2020) · Physiological Reviews · doi:10.1152/physrev.00035.2020 · Cited by 104 · see citing works
Maddaloni, E., D’Onofrio, L., Alessandri, F., Mignogna, C., Leto, G., Pascarella, G., Mezzaroma, I., Lichtner, M., Pozzilli, P., Agrò, F. E., et al. (2020) · Cardiovascular Diabetology · doi:10.1186/s12933-020-01140-2 · Cited by 108 · see citing works
“While measures of visceral adiposity were not available in our study, BMI was found to be higher in patients with the primary outcome, consistent with previous reports in other populations [4, 39].”
ResultObesity in COVID-19: A Systematic Review and Meta-analysis
Ho, J. S. Y., Fernando, D. I., Chan, M. Y., & Sia, C. (2020) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.2020299 · Cited by 89 · see citing works
A systematic review and meta-analysis of obesity and COVID-19 outcomes
Zhang, X., Lewis, A. M., Moley, J. R., & Brestoff, J. (2021) · Scientific Reports · doi:10.1038/s41598-021-86694-1 · Cited by 86 · see citing works
Pasquarelli-do-Nascimento, G., Braz-de-Melo, H. A., Faria, S. S., Santos, I. D. O., Kobinger, G., & Magalhães, K. G. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00530 · Cited by 99 · see citing works
Singh, A., Hussain, S., & Antony, B. (2021) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2021.03.019 · Cited by 76 · see citing works
“In another study, the presence of obesity in NAFLD patients was associated with a sixfold increased risk of severe COVID-19 illness after adjusting for other major co-morbidities [24].”
BackgroundMethodNAFLD and COVID-19: a Pooled Analysis
Sachdeva, S., Khandait, H., Kopel, J., Aloysius, M., Desai, R., & Goyal, H. (2020) · SN Comprehensive Clinical Medicine · doi:10.1007/s42399-020-00631-3 · Cited by 78 · see citing works
“32 in obese NAFLD patients than in non-obese patients with NAFLD [14].”
BackgroundZhu, Z.-Z., Hasegawa, K., Ma, B.-S., Fujiogi, M., Camargo, C. A., & Liang, L.-M. (2020) · Metabolism: Clinical and Experimental · doi:10.1016/j.metabol.2020.154345 · Cited by 76 · see citing works
Machine Learning and AI for Healthcare: Big Data for Improved Health Outcomes
Panesar, A. (2021) · Apress eBooks · doi:10.1007/978-1-4842-6537-6 · Cited by 76 · see citing works
“COVID-19 made it acceptable for everyone to perform tasks in their own time—moving expectancy from time based to task based.”
BackgroundInfluentialLiver injury in the era of COVID-19
Cichoż‐Lach, H., & Michalak, A. (2021) · World Journal of Gastroenterology · doi:10.3748/wjg.v27.i5.377 · Cited by 94 · see citing works
Zhang, H., Ma, S., Han, T., Qu, G., Cheng, C., Uy, J. P., Shaikh, M. B., Zhou, Q., Song, E. J., & Sun, C. (2021) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2021.101313 · Cited by 69 · see citing works
Karuppan, M. K. M., Devadoss, D., Nair, M. G., Chand, H. S., & Lakshmana, M. K. (2021) · Molecular Neurobiology · doi:10.1007/s12035-020-02245-1 · Cited by 76 · see citing works
“Another recent study in China reported that obesity in metabolic-associated fatty liver disease (MAFLD) has ~ 6-fold increased risk for COVID-19 in the age group of 18 to 75 [52].”
BackgroundMahamid, M., Nseir, W., Khoury, T., Mahamid, B., Nubania, A., Sub-Laban, K., Schifter, J., Mari, A., Sbeit, W., & Goldin, E. (2020) · European Journal of Gastroenterology and Hepathology · doi:10.1097/meg.0000000000001902 · Cited by 66
Should patients with obesity be more afraid of COVID‐19?
Rychter, A. M., Zawada, A. E., Ratajczak, A. E., Dobrowolska, A., & Krela‐Kaźmierczak, I. (2020) · Obesity Reviews · doi:10.1111/obr.13083 · Cited by 100 · see citing works
Peres, S. H. D. C. S., de Azevedo‐Silva, L. J., Bonato, R. C. S., Sales-Peres, M. D. C., Pinto, A. C. D. S., & Santiago, J. F. (2020) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2020.07.007 · Cited by 78 · see citing works
Gualtieri, P., Falcone, C., Romano, L., Macheda, S., Correale, P., Arciello, P., Polimeni, N., & LORENZO, A. D. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21134670 · Cited by 73 · see citing works
“A characteristic of COVID-19 patients is obesity [5] and this condition can lead to a dangerous paradox [6].”
BackgroundDalamaga, Μ., Christodoulatos, G. S., Karampela, Ι., Vallianou, N. G., & Apovian, C. M. (2021) · Current Obesity Reports · doi:10.1007/s13679-021-00436-y · Cited by 74 · see citing works
The COVID-19, Obesity, and Food Insecurity Syndemic
Pryor, S. P., & Dietz, W. H. (2022) · Current Obesity Reports · doi:10.1007/s13679-021-00462-w · Cited by 69 · see citing works
Chang, T.-H., Chou, C.-C., & Chang, L.-Y. (2020) · Obesity Reviews · doi:10.1111/obr.13089 · Cited by 61 · see citing works
López-Méndez, I., Aquino-Matus, J., Gall, S. M., Prieto-Nava, J., Juárez-Hernández, E., Uribe, M., & Castro-Narro, G. (2020) · Annals of Hepatology · doi:10.1016/j.aohep.2020.09.015 · Cited by 58 · see citing works
Salacup, G., Lo, K., Gul, F., Peterson, E., Joy, R. D., Bhargav, R., Pelayo, J., Albano, J., Azmaiparashvili, Z., Benzaquen, S., et al. (2020) · Journal of Medical Virology · doi:10.1002/jmv.26252 · Cited by 57 · see citing works
Outbreak of SARS-CoV2: Pathogenesis of infection and cardiovascular involvement
Amirfakhryan, H., & Safari, F. (2020) · Hellenic Journal of Cardiology · doi:10.1016/j.hjc.2020.05.007 · Cited by 57 · see citing works
Hussain, S., Baxi, H., Jamali, M. C., Nisar, N., & Hussain, M. S. (2020) · Diabetes & Metabolic Syndrome Clinical Research & Reviews · doi:10.1016/j.dsx.2020.08.014 · Cited by 60 · see citing works
“2020 [53] Retrospective Wenzhou, China 214 66 25.”
Leija-Martínez, J. J., Huang, F.-Y., Del-Río-Navarro, B., Sánchez-Muñoz, F., Muñoz-Hernández, O., Giacoman-Martínez, A., Hall-Mondragon, M. S., & Espinosa-Velazquez, D. (2020) · Medical Hypotheses · doi:10.1016/j.mehy.2020.109935 · Cited by 54 · see citing works
A meta-analysis of the association between obesity and COVID-19
Yang, J., Ma, Z., & Lei, Y.-C. (2020) · Epidemiology and Infection · doi:10.1017/s0950268820003027 · Cited by 67 · see citing works
“A total of 50 studies [11, 19-67] that included 18260378 subjects were eligible for the meta-analysis.”
BackgroundWollenstein-Betech, S., Silva, A. A. B., Fleck, J. L., Cassandras, C., & Paschalidis, I. (2020) · PLoS ONE · doi:10.1371/journal.pone.0240346 · Cited by 53 · see citing works
Metabolic dysfunction associated fatty liver disease increases risk of severe Covid-19
Sharma, P., & Kumar, A. (2020) · Diabetes & metabolic syndrome · doi:10.1016/j.dsx.2020.06.013 · Cited by 53 · see citing works
Chenchula, S., Vidyasagar, K., Pathan, S., Sharma, S. K., Chavan, M. R., Bhagavathula, A. S., Padmavathi, R., Manjula, M., Chhabra, M., Gupta, R., et al. (2023) · Scientific Reports · doi:10.1038/s41598-023-33314-9 · Cited by 59 · see citing works
Părângă, T. G., Mitu, I., Tanasa, M. P., Roșu, M. F., Miftode, I.-L., Constantinescu, D., Obreja, M., Plesca, C. E., & Miftode, E. G. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252111411 · Cited by 49 · see citing works
“Some studies demonstrated consistently higher levels of TNF-α than IL-6 in severe COVID-19 patients and those with underlying comorbidities such as obesity, chronic heart failure, and hypertension [58–60].”
HMGB1: A Possible Crucial Therapeutic Target for COVID-19?
Street, M. (2020) · Hormone Research in Paediatrics · doi:10.1159/000508291 · Cited by 50 · see citing works
Arutyunov, G. P., Tarlovskaya, E. I., Arutyunov, A. G., Belenkov, Y. N., Конради, А. О., Lopatin, Y. M., Rebrov, A. P., Tereshchenko, S. N., Chesnikova, A. I., Hayrapetyan, H. G., et al. (2021) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2021-4470 · Cited by 53 · see citing works
Strauss, A., Boyarsky, B., Wang, J. M. G., Werbel, W., Durand, C., Avery, R., Jackson, K., Kernodle, A., Baker, T., Snyder, J., et al. (2020) · American Journal of Transplantation · doi:10.1111/ajt.16373 · Cited by 49 · see citing works
Proper Management of People with Obesity during the COVID-19 Pandemic
Lim, S. K., Shin, S. M., Nam, G. E., Jung, C. H., & Koo, B. K. (2020) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes20056 · Cited by 71 · see citing works
Raeisi, T., Mozaffari, H., Sepehri, N., Darand, M., Razi, B., Garousi, N., Alizadeh, M., & Alizadeh, S. (2020) · Eating and Weight Disorders · doi:10.1007/s40519-021-01269-3 · Cited by 45 · see citing works
Kushner, T., & Cafardi, J. (2020) · Clinical Liver Disease · doi:10.1002/cld.974 · Cited by 45 · see citing works
Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know?
Sharma, P., Kumar, A., Anikhindi, S., Bansal, N., Singla, V., Shivam, K., & Arora, A. (2020) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2020.12.006 · Cited by 44 · see citing works
“In another study By Zheng et al.(26) 66 patients [obese, n = 45 and nonobese, n = 21] with COVID-19 and MAFLD were included.”
BackgroundInfluentialMuntsant-Soria, A., & Giménez‐Llort, L. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.572583 · Cited by 48 · see citing works
Involvement of the Liver in COVID-19: A Systematic Review
Kariyawasam, J., Jayarajah, U., Abeysuriya, V., Riza, R., & Seneviratne, S. (2022) · American Journal of Tropical Medicine and Hygiene · doi:10.4269/ajtmh.21-1240 · Cited by 43
“The severity of COVID-19 was much higher in obese than nonobese NAFLD patients.(114) According to Prins et al.”
BackgroundPοlyzos, S. A., & Mantzoros, C. S. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154318 · Cited by 45 · see citing works
Obesity pandemic during COVID-19 outbreak: Narrative review and future considerations
Cava, E., Neri, B., Carbonelli, M. G., Riso, S., & Carbone, S. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.02.038 · Cited by 54 · see citing works
“The association of obesity and COVID-19 severity remained significant, even after statistical adjustments for age, sex, smoking, DM, hypertension, and dyslipidemia [22].”
BackgroundPATHOLOGICAL ANATOMY OF INFECTION CAUSED BY SARS-COV-2
Kogan, E., Коган, Е. А., Berezovsky, Y., Березовский, Ю. С., Protsenko, D. D., Проценко, Д. Д., Bagdasaryan, T. R., Багдасарян, Т. Р., Gretsov, E., Грецов, Е. М., et al. (2020) · Russian Journal of Forensic Medicine · doi:10.19048/2411-8729-2020-6-2-8-30 · Cited by 41 · see citing works
“Лимфоцитарный перикардит в сочетании с COVID-19-ассоциированным лимфоцитарным миокардитом.”
InfluentialPavlov, V. A. (2020) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2020.107794 · Cited by 49 · see citing works
“presence of diagnosed NAFLD additionally worsens COVID-19 progression comparedwith obesitywithoutNAFLD (Zheng et al., 2020).”
Lange, K. W. (2020) · Food Science and Human Wellness · doi:10.1016/j.fshw.2020.08.005 · Cited by 50 · see citing works
SARS-CoV-2 infection and liver involvement
Luo, M., Ballester, M., Soffientini, U., Jalan, R., & Mehta, G. (2022) · Hepatology International · doi:10.1007/s12072-022-10364-1 · Cited by 39 · see citing works
WGO Guidance for the Care of Patients With COVID-19 and Liver Disease
Hamid, S., da Silva, M. Á., Burak, K., Chen, T., Drenth, J., Esmat, G., Gaspar, R., Labrecque, D., Lee, A., Macedo, G., et al. (2020) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000001459 · Cited by 38 · see citing works
Verma, A., Khorsandi, S., Dolcet, A., Prachalias, A., Suddle, A., Heaton, N., & Jassem, W. (2020) · Liver international (Print) · doi:10.1111/liv.14552 · Cited by 38
Factors Associated with Increased Morbidity and Mortality of Obese and Overweight COVID-19 Patients
Beshbishy, A. M., Hetta, . F., Hussein, D. E. E., Saati, A. A., Uba, C. C., Rivero-Pérez, N., Zaragoza-Bastida, A., Shah, M. A., Behl, T., & Batiha, G. E. (2020) · Biology · doi:10.3390/biology9090280 · Cited by 53 · see citing works
“[56] revealed that obesity could exacerbate sever acute coronavirus-2 (SARS-CoV-2) respiratory syndrome (SARS-CoV-2).”
BackgroundBody Mass Index and Prognosis of COVID-19 Infection. A Systematic Review
Peres, K., Riera, R., Martimbianco, A., Ward, L., & Cunha, L. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00562 · Cited by 37 · see citing works
Gao, F., Zheng, K. I., Yan, H., Sun, Q.-F., Pan, K.-H., Wang, T.-Y., Chen, Y.-P., Targher, G., Byrne, C., George, J., et al. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.604100 · Cited by 36 · see citing works
“Some of these patients have been reported in a previous study (14).”
Self-citation
- Authors
- Zheng, K. I., Gao, F., Wang, X.-B., Sun, Q.-F., Pan, K.-H., Wang, T.-Y., Ma, H.-L., Chen, Y.-P., Liu, W.-Y., George, J., & Zheng, M.-H.
- Affiliations
- First Affiliated Hospital of Wenzhou Medical University (CN)
- The University of Sydney (AU)
- Wenzhou Medical University (CN)
- Corresponding author
- George, Jacob
- Zheng, Ming-Hua
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 108
- Pages
- 154244
- ISSN
- 0026-0495 (ISSN-L)
- PMC
- PMC7166301
- OpenAlex
- W3016610783
- Cited by
- 332
- References
- 14
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 10 · 2023: 28 · 2022: 44 · 2021: 101 · 2020: 140
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- The Sydney eScholarship Repository (The University of Sydney) (submittedVersion)
- Funders
- National Natural Science Foundation of China (81500665)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- obesity, COVID-19 severity, metabolic-associated fatty liver disease, non-alcoholic fatty liver disease, comorbidities, SARS-CoV-2, disease severity risk factors, metabolic risk factors, respiratory disease risk, hypoxia, innate immunity, lung function, SARS-CoV-2 viral load, SARS-CoV-2 variants
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Obesity, Pneumonia, Viral, Risk Factors, Coronavirus Infections, Young Adult, Pandemics, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
