Excess weight increases the risk for neurological and neuropsychiatric symptoms in post-COVID-19 condition: A systematic review and meta-analysis

Background/purpose: Excess weight has been identified as a potential risk factor for the development of post-COVID-19 condition (PCC). This review investigates whether excess weight increases the risk of neurological and neuropsychiatric symptoms associated with PCC. Methods: Studies published up to July 2023 were searched independently across eight electronic databases to evaluate the risk of developing neurological and neuropsychiatric symptoms more than 12 weeks post-infection between exposure and controls groups (excess weight vs. normal weight; obesity vs. non-obesity). Meta-analyses were conducted under a random-effects model. Results: Of the 10,122 abstracts screened, 18 studies (n = 139,091 adults) met the inclusion criteria and reported PCC symptoms according to nutritional status. These studies included 79,050 individuals with excess weight vs 57,926 normal-weight individuals and 30,694 individuals with obesity vs 107,612 non-obese individuals. The presence of excess weight in PCC significantly increased the risk of depression (RR = 1.21; 95% CI: 1.03-1.42), headache (RR = 1.21; 95% CI: 1.09-1.35), memory issues (RR = 1.43; 95% CI: 1.24-1.65), sleep disturbance (RR = 1.31; 95% CI: 1.16-1.48), and vertigo (RR = 1.21; 95% CI: 1.04- 1.41). Obesity significantly increased the risk of headache (RR = 1.41; 95% CI: 1.34- 1.49), smell disorder (RR = 1.15; 95% CI: 1.09-1.21), taste disorder (RR = 1.21; 95% CI: 1.07-1.36), and vertigo (RR = 1.44; 95% CI: 1.35-1.53). Conclusions: Excess weight or obesity increases the risk of experiencing neuro-symptoms related to PCC. Individuals with these conditions urgently need enhanced personalized care management in current post-pandemic context.