Caution Advised

Adding Up: More Risk in COVID-19 with Obesity

Evidence continues to accumulate that obesity is not helpful when a person develops COVID-19. Four new publications point to added risks. One of them documents higher prevalence of obesity in ICU patients with COVID-19 in France. Then a pair of studies in China finds triple the risk for severe symptoms in COVID patients with obesity. Finally, a fourth paper finds that the odds for a COVID patient having a lung clot are nearly three times higher with obesity.

ICU Patients in France

The first of these three studies appears in Lancet Diabetes and Endocrinology. It’s an analysis of 357 ICU patients with COVID-19 and 1,210 ICU patients without COVID. After adjusting for age and sex, the researchers found that the odds of an ICU patient with the coronavirus having obesity were nearly three times higher (odds ratio, 2.87), compared to ICU patients without the infection. Even after adjusting for other potential confounding variables, the relationship was significant, with odds approximately doubled.

COVID-19 Severity in China

A pair of studies in Diabetes Care examined the risk of severe COVID symptoms for different cohorts of patients with obesity. Their findings were similar. The odds of developing severe symptoms were approximately three times higher for patients with obesity, even after adjusting for multiple variables. The association was weaker in women, but in men, the risk was more than five times higher with obesity.

Risk of Lung Clots

The final study comes from the Henry Ford Health System in Detroit. Neo Poyiadji and colleagues studied CT images of blood vessels in the lungs of 328 patients with COVID-19. They found pulmonary embolisms in 72 of them. A multivariate analysis that the odds of patients with a BMI in the range of obesity having an embolism was 2.7 times higher than those at a lower BMI.

Caution Warranted

Of course, even with this accumulation of evidence, we have much more to learn. But we have multiple datasets suggesting that the risk of bad outcomes is higher in COVID-19 for patients with obesity. We also know that inflammation is a significant factor in both COVID-19 and obesity. So we have a clue for one of the factors that might explain the link. Another factor is the influence of obesity on lung function.

Knowing all this, HAES advocates who try to dismiss the risks that COVID-19 presents for people with obesity are dispensing misinformation. They are not helping the people who listen to them. Though more research will bring more refined insights, one thing is clear, says researcher and physician Jun Chen:

Clinicians should pay close attention to patients with obesity, who should be carefully managed with prompt and aggressive treatment.

And thus people living with obesity should take special care to avoid this virus and be vigilant about seeking care if they develop the virus. Carelessness and delays can be deadly.

Click here, here, here, and here for these four studies. For further perspective, click here, here, and here.

Caution Advised, photograph © Steve Jurvetson / flickr

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May 21, 2020