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Primary Care

Obesity and COVID-19

Obesity is a common, serious chronic disease that puts people at risk for other serious health issues. Studies have shown that adults with excess weight are at even greater risk for severe illness from COVID-19. In fact,  78 percent of U.S. patients hospitalized with COVID-19, spanning all ages and races, were overweight or obese.

Obesity is linked to impaired immune function, decreased lung capacity and reserve, making ventilation more difficult. Chronic inflammation, reduced immune response or blunted treatment response put overweight or obese adults at greater risk during the COVID-19 pandemic. A study of COVID-19 cases suggests that the risks of hospitalization, intensive care unit admission, invasive mechanical ventilation and death are higher with increasing BMI (body mass index).

Mechanical Issues in Obese COVID Patients

The issues of immune and lung dysfunction that render people with obesity vulnerable to severe COVID-19 begin with physical mechanics. Fat in the abdomen pushes up on the diaphragm, impinging on the lungs and restricting airflow. Reduced lung volume collapses airways in the lower lobes of the lungs, where more blood arrives for oxygenation than in the upper lobes.

These mechanical issues lead to other problems, like blood that has a tendency to clot. Immunity is also weakened in obese people because fat cells infiltrate the organs where immune cells are produced and stored. People with obesity not only have fewer immune cells, but less effective ones.

Beyond impaired immune response, people with obesity also suffer from chronic inflammation. Research indicates that people with higher levels of inflammatory proteins were among the top signs in predicting that the COVID case may become critical.

Next Steps for Healthcare Providers

The impact of obesity and COVID-19 extends to the 36.5 percent of Americans who are obese. Poverty, lack of access to healthy foods, lack of health insurance and poor exercise opportunities often lead to higher rates of obesity. In addition, many people with obesity may avoid seeking medical attention due to fear of being stigmatized in the healthcare environment.

Health providers can play an important role in managing obesity. In fact, many are using the pandemic as an opportunity to further educate their patients about lifestyle modifications, including healthy eating and physical activity, they can make to lose weight and avoid health risks.