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Last updated: Nov 03, 2021
4 min read

Obesity as a risk factor for severe COVID-19

Obesity is a common chronic medical condition in the United States. According to the Centers for Disease Control and Prevention (CDC), over 40% of American adults have obesity. In addition to an increased risk of many other health problems, including heart disease, diabetes, and high blood pressure, obesity can increase the risk of developing severe COVID-19, likely more so in people under the age of 60.

Important

Information about the novel coronavirus (the virus that causes COVID-19) is constantly evolving. We will refresh our novel coronavirus content periodically based on newly published peer-reviewed findings to which we have access. For the most reliable and up-to-date information, please visit the CDC website or the WHO’s advice for the public.

As more and more people are affected by COVID-19 around the world, researchers learn more about what puts a person at risk of developing a severe infection. 

Studies strongly suggest that people with obesity have a higher risk of developing symptomatic COVID-19 than those without obesity. They are also more likely to have a severe case, ultimately requiring more frequent hospitalization and mechanical ventilation. Obesity was also associated with an increased risk of death from COVID-19. Obesity may increase the risk of severe COVID-19 by reducing lung function and increasing inflammation. Getting vaccinated is a good way to prevent the spread of coronavirus and protect yourself and those around you.

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How does obesity affect your risk for COVID-19?

COVID-19 affects certain groups of people more than others. Age is a risk factor for having severe symptoms, especially if you are over the age of 64 or live in a nursing home. Other risk factors include chronic medical conditions like diabetes, lung disease, or heart problems. However, studies show that obesity is also a risk factor for severe COVID-19 illness, especially for people under the age of 65 (Anderson, 2020). And it’s not just because obesity puts you at risk for other medical problems. People with obesity—regardless of other health conditions—develop severe COVID-19 symptoms at a higher rate than people without obesity (Zhou, 2021).

A study of over 4,000 people in New York who tested positive for COVID-19 found that people with obesity were more than twice as likely to require hospitalization for COVID-19 than those without. Of all of the chronic medical conditions in the study, obesity ranked higher than diabetes, heart disease, or lung problems as a risk factor for critical COVID-19 (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 twice as likely to be admitted to the intensive care unit (ICU) (Lighter, 2020).

Data from France also suggested a higher rate of obesity in the COVID-19 patients who needed to be admitted to the ICU. In this study, people 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). 

One large pooled analysis that examined 75 different studies in people with COVID-19 found that obesity on its own increased the risk for developing symptomatic coronavirus infection, more than doubled the risk for requiring hospitalization and increased the risk of death by nearly 50% (Popkin, 2020).

Why does obesity increase the risk?

Researchers have many theories on this front, but still don’t have a solid understanding of why obesity increases the risk for severe COVID-19

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 in your body, 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 reduce lung function, making people with obesity more likely to have breathing problems (Qingxian, 2020). 

What can you do?

Whether or not you have obesity, you can take steps to help avoid catching or spreading the coronavirus. Getting vaccinated is a great way to protect yourself and those around you. There are plenty of local resources available to find a vaccination site, and remember that COVID-19 vaccines are always free. Speak to your local pharmacy to find the vaccination center closest to you.

References

  1. Anderson, M. R., Geleris, J., Anderson, D. R., et al. (2020). Body mass index and risk for intubation or death in SARS-CoV-2 infection : A retrospective cohort study. Annals of Internal Medicine, 173(10), 782–790. Doi: 10.7326/M20-3214 Retrieved from: https://pubmed.ncbi.nlm.nih.gov/32726151/
  2. Centers for Disease Control and Prevention (CDC) Prevalence of obesity and severe obesity among adults: United States, 2017–2018 (2020-a, February). Retrieved on Sept. 9, 2021 from https://www.cdc.gov/nchs/products/databriefs/db360.htm
  3. Centers for Disease Control and Prevention (CDC) – Coronavirus Disease 2019 (COVID-19). (2020, April 23). Retrieved 27 April 2020, from https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/index.html
  4. Centers for Disease Control and Prevention (CDC). FastStats – Overweight Prevalence. (2016, June 13). Retrieved on Apr. 27, 2020, from https://www.cdc.gov/nchs/fastats/obesity-overweight.htm
  5. Petrilli, C., Jones, S., Yang, J., Rajagopalan, H., O’Donnell, L., & Chernyak, Y. et al. (2020). Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. BMJ; 369 :m1966. doi: 10.1136/bmj.m1966. Retrieved from https://www.bmj.com/content/369/bmj.m1966
  6. Popkin, B. M., Du, S., Green, W. D., et al. (2020). Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships. Obesity reviews: International Association for the Study of Obesity, 21(11), e13128. Doi: 10.1111/obr.13128. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/32845580/
  7. Qingxian, C., Fengjuan, C., Fang, L., Xiaohui, L., Tao, W., & Qikai, W. et al. (2020). Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Preprints with The Lancet. doi: 10.2139/ssrn.3556658. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32409502/ 
  8. Simonnet, A., Chetboun, M., Poissy, J., Raverdy, V., Noulette, J., & Duhamel, A. et al. (2020). High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity, 28(7), 1195–1199. doi: 10.1002/oby.22831. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/32271993
  9. Zhou, Y., Chi, J., Lv, W., & Wang, Y. (2021). Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes/Metabolism Research and Reviews, 37(2), e3377. Doi: 10.1002/dmrr.3377. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32588943/