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Last updated August 7, 2020. 4 minute read

Obesity as a risk factor for COVID-19

Several recent studies strongly suggest that people with obesity have a higher risk of having severe COVID-19 symptoms, leading to hospitalization and mechanical ventilation. Obesity may increase the risk of severe COVID-19 by contributing to reduced lung function and elevated immune system response.

What is obesity?

Obesity is a common chronic medical condition, especially in the United States. According to the Centers for Disease Control and Prevention (CDC), over 40% of American adults are classified as obese (CDC, 2016). Obesity is determined by using your body mass index (BMI), which is based on your weight and height. People with a BMI of 30 kg/m2 or higher are considered to have obesity. This medical condition is more than just a weight problem—obesity increases your risk of many other health problems, including heart disease, diabetes, and high blood pressure. In the case of coronavirus disease 2019 (COVID-19), obesity also increases your risk of having severe COVID-19 symptoms, perhaps more so in people younger than 60 (Lighter, 2020).

Vitals

  • Obesity is a chronic medical condition that affects almost 40% of American adults
  • Several recent studies strongly suggest that people with obesity have a higher risk of having severe COVID-19 symptoms, leading to hospitalization and mechanical ventilation.
  • Obesity may increase the risk of severe COVID-19 by contributing to reduced lung function and elevated immune system response.
  • Practice social distancing and minimize unnecessary contact with others.

Obesity as a risk factor for severe COVID-19 symptoms

COVID-19 affects certain groups of people more than others. Age is a significant risk factor for having severe symptoms, specifically if you are over the age of 64 or live in a nursing home. So is having diabetes or other chronic medical conditions, like lung or heart problems. However, scientists have recently discovered that obesity is another risk factor for severe COVID-19 illness, especially for people under the age of 60. And it’s not just because obesity puts you at risk for other medical problems. People with obesity—regardless of other comorbidities—seem to be developing severe COVID-19 symptoms at a higher rate than non-obese people.

A study looking at over 4,000 people in New York who tested positive for COVID-19 found that almost 40% of the people with COVID-19 who needed hospitalization had obesity (Petrilli, 2020). Of all of the chronic medical conditions that were associated with critical COVID-19 symptoms, obesity ranked higher than diabetes, heart disease, or lung problems in this particular study (Petrilli, 2020). Data from New York hospitals also showed that people who were younger than 60 and had a BMI >35 kg/m2 were almost two times as likely to be admitted to the intensive care unit (ICU) (Lighter, 2020).

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Other data from France suggested that there was a higher rate of obesity in the COVID-19 patients who needed to be admitted to the ICU (Simonnet, 2020). Also, patients with a BMI >35 kg/m2 required intubation (mechanical ventilation) due to severe COVID-19 symptoms over 90% of the time (Simonnet, 2020). Looking at one hospital in China during January and February 2020, researchers noted that people with obesity were more than twice as likely to progress to severe pneumonia, regardless of other comorbidities (Qingxian, 2020). Many of these studies are small or only examine a particular population, and most are not peer-reviewed. Scientists are continuing to study COVID-19, but the data strongly suggests a link between severe COVID-19 disease and obesity.

Why does obesity increase risk?

COVID-19 is a new illness that has only been around since December 2019, so there is a lot about it that we just don’t know. One thing that seems to play a role in this disease is higher levels of inflammation and immune system response in the body. Obesity also tends to increase inflammation, so this may be why people with obesity are at higher risk of severe disease with COVID-19 (Petrilli, 2020). Another thought is that obesity may decrease lung function, making people with obesity more likely to have airway problems (Qingxian, 2020). Regardless of the theories, people with obesity need to be extra vigilant as they are at higher risk for developing severe symptoms and requiring hospitalization.

What can you do?

Whether or not you have obesity, you can take steps to help avoid getting COVID-19. Whenever possible, minimize contact with others and practice social distancing (stay away from large groups and remain at least six feet apart from others). Wash your hands frequently and avoid touching your face. When in public, wear a mask or cloth face covering (this protects others from you, in case you happen to be sick).  Lastly, if you do think you are sick, do not hesitate to seek out medical care.