Does Obesity Raise the Risk for Long COVID?

A new paper in Diabetes, Obesity, and Metabolism shows an association between obesity and the risk for long COVID. People with moderate or severe obesity have a 28 to 30 percent higher risk of hospital stays after the acute phase of COVID in this study. But it’s not the first study noting this link. In fact, a paper in Nature Medicine recently noted the same finding.

This link to obesity is new and requires further study for greater clarity. However, one thing is clear enough already. Long COVID is a serious concern. Ali Aminian and colleagues from Cleveland Clinic authored the study in DOM. They conclude:

“During 10-month follow-up after the acute phase of COVID-19, an additional 44% of patients required hospital admission and 1% died. These findings suggest a profound magnitude of the public health impact of PASC [long COVID] in the setting of worldwide infection.”

A Study of 2,839 Cleveland Clinic Patients

Aminian et al studied a cohort of 2,839 patients of the Cleveland Clinic. They all had a positive COVID test, survived the acute infection, and did not require an ICU admission. Fully 44 percent of those had to have a follow-up hospital stay after the acute phase. This was 28 percent more likely for patients with moderate obesity. The risk was 30 percent higher for those with severe obesity.

Inflammation, immune dysfunction, and comorbidities that come with obesity might help to explain this risk, say these researchers. Nonetheless, we note that the elevated risk found in this context is not so high as the doubling of risk for death with severe obesity in the acute phase of COVID.

Data from the COVID Symptom Study App

The study in Nature Medicine uses data from 4,182 patients who logged their symptoms in the COVID Symptom Study app. As in the Cleveland Clinic study, these investigators did not find an elevation in risk for long COVID with obesity that matched the level of risk seen in the acute phase of COVID. Patients with obesity made up 24 percent of those with only short COVID symptoms. But they were 28 percent of the patients with long COVID.

In addition to obesity, older age and female sex predicted a higher risk of long COVID. Asthma was also associated with a higher risk of long COVID.

More Work Needed

We will be hearing a lot more about long COVID. The understanding of it right now is very sketchy and it may be tricky to study. So we take these findings with a grain of salt. Without a doubt, long COVID is a problem we need to come to terms with. Whether obesity is a major factor or not is something that future research will have to tell us.

Click here for the Aminian study and here for the study in Nature Medicine. For more on long COVID, click here, here, and here.

Long Foggy Road, photograph by Christina VanMeter, licensed under CC BY-NC 2.0

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June 4, 2021