Obesity is associated with a greater risk of a severe COVID-19 infection, according to a new analysis published in Circulation. It may not necessarily be an independent risk factor, the authors noted, but it appears to be a consistent indicator that serious complications may arise.
“We suggest obesity or excess ectopic fat deposition may be a unifying risk factor for severe COVID-19 infection, reducing protective cardiorespiratory reserve as well as potentiating the immune dysregulation that appears, at least in part, to mediate the progression to critical illness and organ failure in a proportion of patients with COVID-19,” wrote lead author Naveed Sattar, MD, University of Glasgow, and colleagues.
Sattar et al. highlighted data from multiple studies, noting that individuals with a BMI higher than 35 appeared to be at an especially high risk. Obesity is “causally related” to numerous conditions, they wrote, and those associations all seem relevant as healthcare providers consider how patients could be affected by this ongoing pandemic.
“There are multiple pathways by which obesity (or excess ectopic fat) may increase the effect of COVID-19 infection,” the authors added. “These include underlying impairments in cardiovascular, respiratory, metabolic, and thrombotic pathways in relation to obesity, all of which reduce reserve and ability to cope with COVID-19 infection and the secondary immune reaction to it.”
The authors added that patients should be informed about any relationship between obesity and COVID-19, though “it is important to communicate risks without causing anxiety.”
“People worldwide should be encouraged to improve their lifestyle to lessen risk both in the current and subsequent waves of COVID-19,” Sattar and colleagues wrote. “In addition to increasing activity levels, there should be improved messaging on better diet, focusing on simpler advice to help people adopt sustainable changes.”
Overall, the team concluded, the COVID-19 pandemic acts as yet another reminder that preventing obesity can make a significant impact on preventing “chronic disease and greater adverse reactions to viral pandemics.”