Piazza dei Signori in Padua, Italy, Deserted at Night

Combining the Risks of Coronavirus with Obesity

Two things are now very apparent about the coronavirus epidemic. First, it affects all of us. But second, the health affects are wildly different for different people. For many people, the symptoms are mild, sometimes even negligible. However, it can also be deadly – especially for people older than 60 or people who have other health problems. So this begs a question. What happens when you add the risks of the new coronavirus with obesity?

What We Know About COVID-19

Here’s the thing. Right now we don’t know everything about this new coronavirus. It’s new. Doctors are working hard to understand it and share their observations to build that knowledge. But that means our evidence is observational. It’s getting better as we go and people are doing the very best they can under difficult circumstances.

But with all that said, we certainly do know that this is a respiratory virus that causes extreme respiratory problems in a small number of patients. That’s when the disease becomes life-threatening. In China, about 15 percent of COVID-19 patients needed hospitalization. The number has been much higher in Italy – perhaps as much as 50 percent. In China, a third of hospitalized patients needed treatment in an ICU. But in Italy, the proportion was smaller – about ten percent. Liz Specht assembled these numbers in a fascinating, albeit disturbing, report for Stat.

People with Obesity at Risk

We also know who is at risk for more serious complications of COVID-19. They are older people and people with serious chronic diseases: heart disease, diabetes, and lung disease. Note that these are all diseases that are more common in people with obesity.

Caroline Apovian is a past president of the Obesity Society and Professor of Medicine at Boston University. She explains why the combination of the new coronavirus and obesity brings added risks:

Many with severe obesity have hypoventilation syndrome. Obesity is also a chronic state of inflammation even in patients who haven’t yet developed complications like diabetes or heart disease. We need a better tool than BMI to assess this risk because it doesn’t always reflect a patient’s true risk.

With this in mind, it’s not completely surprising when Luca Busetto in Italy tells us:

According to a very recent report of the Italian National Institute of Health (Istituto Superiore di Sanità) we had two COVID-19 deaths in people under 40: a man 39 years old with cancer and a woman 39 affected by diabetes, obesity, and other complications. It will be interesting to look at the impact of obesity on the severity of COVID-19 in younger people.

He reminds us that these two cases are anecdotal, but they are worth noting.

Staying Safe

All of this adds up to a very simple message. We must take this new coronavirus seriously. All of us. We are all potential carriers who could wind up being responsible for making our brothers, sisters, and loved ones seriously ill. That means keeping our distance from all other people. It means washing our hands frequently. We must be careful with sneezes and coughs and to avoid touching our faces.

And for those of us who are living with obesity, we should be especially careful about staying safe. Mixing the new coronavirus with obesity can be a bad combination.

For more information on COVID-19, we recommend CDC resources here. You can find the data on mortality from COVID-19 in Italy here (yes, it’s in Italian, but Google Translate can help you with that). Finally, this analysis of people at risk of serious illness from the new coronavirus is worth a read.

Piazza dei Signori in Padua, Italy, Deserted at Night, photograph © Federica Stella, MD

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March 16, 2020

4 Responses to “Combining the Risks of Coronavirus with Obesity”

  1. March 16, 2020 at 10:19 am, David Brown said:

    Here is news from the laboratory. “A team of researchers from Sunnybrook, McMaster University(opens in a new window) and the University of Toronto has isolated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for the ongoing outbreak of COVID-19.


  2. March 16, 2020 at 10:24 pm, John Dixon said:

    The recent data from Wuhan indicates hypertension is of particular risk. The reason is unclear but with prevalence higher in those with obesity this should also be considered. There have been suggestion this may related partly to some blood pressure medications. There is so much we need to understand.

    • March 17, 2020 at 4:54 pm, Ted said:

      Excellent perspective, John. Thanks for sharing it!

  3. March 27, 2020 at 2:03 am, Adrienne McGuire said:

    Thanks for this intriguing article on the risks of combining COVID-19 and obesity. We appreciate having reliable and up-to-date information at our fingertips. Keep up the great work!