Can Diet, Or More Specifically Obesity, Increase My COVID Risk?

Many hospitals, doctors and epidemiologists are feverishly searching for patterns in those patients who have become sick from the SARS-CoV-2 virus. Some individuals have minimal symptoms and recover quickly and others have severe immune responses.  It’s not completely clear why there is such a wide spectrum of symptoms.

We know that older age and chronic health conditions like high blood pressure and heart disease increase the risk of severe COVID-19. The Centers for Disease Control and Prevention now also lists extreme obesity as a high risk. Two recent studies, Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection: A Retrospective Cohort Study and Obesity and Mortality Among Patients Diagnosed With COVID-19: Results From an Integrated Health Care Organization | Annals of Internal Medicine, show that obesity is an independent risk factor for developing an infection from the SARS-CoV-2 virus. Obese individuals often have other health conditions such has diabetes, high blood pressure or heart disease but interestingly these studies show that obesity by itself is a risk factor.

In addition, the obesity risk is observed more significantly in men  under the age of 60.

Among women with the illness, body mass index does not appear to be independently associated with an increased risk of dying at any age. The authors of the study suggest that women carry weight differently than men who tend to have more visceral and abdominal fat.

This recent NY times article also addresses the question around obesity. Obesity and the coronavirus can be a dangerous combination. 

In addition, obesity can restrict breathing, making it more difficult to clear pneumonia and other respiratory infections. Fat is known to be a source of pro-inflammatory chemicals, promoting a state of chronic inflammation in the body even before Covid-19 sets in. Unfortunately this translates to obesity causing metabolic changes and abnormalities, even in the absence of diabetes.

For those individuals who have BMI greater than 40 or extreme obesity, reducing potential exposures and reducing their overall risk will be crucial.  Even small amounts of weight reduction can help, so as always a healthy diet and any amount of body movement is a good prescription.

(Prerana Sangani, MD, August 17, 2020)