Obesity and Coronavirus – how being overweight affects the course of COVID-19?

The new SARS-CoV-2 coronavirus has already completely paralysed the world at the beginning of 2020, affecting up to now nearly 50 million people in the whole world. COVID-19, the disease caused by the new virus, attacks the respiratory tract and can lead to severe breathing difficulties, cardiopulmonary failure and even death. 

Although there is not much information available on effective protection against infection or on the treatment of this virus, it is known that the elderly in particular are at high risk. The second group at high risk of serious complications from COVID-19 are people that are obese. How being overweight affect the course of COVID-19 and why the new coronavirus might be particularly dangerous for obese people?

How does obesity affect a person’s overall health?

Obesity is a serious problem in modern society and a disease of civilisation that we still do not seem to be able to cope with. More and more people in the world suffer from obesity, having a BMI over 30 and it also elevates health conditions and coexisting diseases typical for obese people.
Cardio-respiratory diseases, type 2 diabetes, respiratory problems, lack of physical fitness, infertility, hypertension or decreased immunity are just some of the complications resulting from excessive body weight. Unfortunately, in the face of the SARS-CoV-2 coronavirus pandemic, these complications may contribute to COVID-19 infection and its more severe course.

Obesity can decrease the production of interferons that affect the body’s defences against infections, and excessive adipose tissue can facilitate the spread of the virus in the body and make it more difficult to fight off. Obesity also causes many chronic inflammations for the body, which significantly weakens the immune system. Even before the coronavirus pandemic, obese people are at higher risk when it comes to contracting influenza and other viral illnesses as well as experiencing acute airway inflammation.

Obesity and SARS-CoV-2 coronavirus

Currently, in many research units worldwide, studies on the relationship of various diseases and health conditions to morbidity and serious complications following COVID-19 are being carried out and that is why the verification of researchers’ findings and extracting true, confirmed information from the pool of conjecture and original findings will continue for years to come.

For now, however, there is a strong enough basis to argue that obesity may play a role in the increased risk of COVID-19 due to the complications it brings to the overall body health. Many people that suffer from obesity develop multiple comorbidities including diabetes, high blood pressure and general cardiovascular problems.

Researchers from the University in North Carolina, analysing publications and studies from around the world presented so far, came to the conclusion, that obese people (BMI over 30) have a significantly higher risk of being hospitalised for COVID-19 (113% higher), as well as are at higher risk of being admitted to an intensive care unit due to the severe course of the disease (74% higher than other patients).

The researchers also found that obese people have a 48% risk of dying from complications after SARS-CoV-2. All the studies obtained so far seem to confirm these data and indicate that obesity can be a serious obstacle for people wanting to protect themselves from COVID-19.

Why might COVID-19 be dangerous to obese people?

The team that conducted the research described above, including Professor Barry Popkin of the Nutrition Department at the University of North Carolina, came to a conclusion, that given the links between obesity and serious diseases such as type II diabetes, heart disease, hypertension and chronic kidney and liver disease, its impact on the increased risk of COVID-19 may be quite obvious. 

They analysed immunological and medical data of COVID-19 cases worldwide and were able to trace direct connections between the increased risk of COVID-19 and serious complications after the disease and obesity. A significant overweight and obesity leads to strong metabolic changes, including insulin resistance and intern inflammation which makes it difficult for the body to fight off infection on its own.

Will the treatment of obesity reduce the risk of complications after COVID-19?

Although the research and analysis that has been carried out seems to indicate quite clearly the link between obesity and a higher risk of contracting COVID-19, there is currently no reason to question the effectiveness of possible vaccines for the disease caused by the new coronavirus in obese people. Such studies will only be able to be carried out once an effective method of eradicating the virus has been developed, although the issue of obesity should be taken into consideration already at the stage of the vaccine development. 

The only concern that seems to be of real importance now in this regard is the fact that, in the case of the flu vaccine, its effectiveness is actually lower in obese people. What does it mean in practice?

Although, due to the coronavirus pandemic, many people are spending more time at home, sedentary, without the chance to go to the gym or lead an active lifestyle, we should not give in to the temptation to eat more, give up diet and exercise and fight the risk of becoming overweight. Society, including in Poland, is already struggling with the problem of obesity and overweight. Staying on track to treat it and controlling obesity-related comorbidities during coronavirus pandemic can have a real impact on the risk of contracting COVID-19 and of the complications linked to it.