Smith College

In populations with a high prevalence of obesity, such as the United States, COVID-19 will affect younger populations more than reported in other countries with lower prevalences of obesity. For example, in a large study of COVID-19 ICU patients in Italy, the median age was 63 years, with only 13% of patients younger than 51 years old and a prevalence of obesity of only 20% compared to the US' 40%.



Implications of Obesity in Patients with COVID-19

Stefan, N., Birkenfeld, A. L., Schulze, M. B., &amp; Ludwig, D. S. (2020). Obesity and impaired metabolic health in patients with COVID-19. Nature Reviews Endocrinology, 16(7), 341-342. doi:10.1038/s41574-020-0364-6
https://www.nature.com/articles/s41574-020-0364-6?fbclid=IwAR0EmauIq9e3_gcCl9wHzS_z1f6RYj5QRnRFw0ALH2MmdfI3Xv6WJw5e-pw

Obesity and impaired metabolic health in patients with COVID-19

Diagram outlining Obesity-Related Comorbidities and Mechanisms of Severe COVID-19 Infection 

Obesity can restrict ventilation by impeding diaphragm excursion, inhibiting immune responses to viral infection, influencing inflammatory responses, and inducing diabetes and oxidant stress which negatively affects cardiovascular function. 

Additionally, Fat cells express ACE2 (the protein COVID-19 must bind with in order to gain entry into a cell) at fairly high levels. This means that obese individuals could become more infectious even as their symptoms get better.

Why the COVID-19 Risks are Higher with Obesity

Studies concluded in two various health systems showed that patients with obesity had a higher rate of hospitalization. More specifically, patients with a BMI greater than or equal to 40 had a very high risk of hospitalization and worsened symptoms, and even patients with a BMI greater than or equal to 30 were at a higher risk than individuals in the normal weight range. 
Risks possibly could be lessened if patients in this vulnerable group could implement exercise or activity into their daily routine as recommended by primary care provider.

Learn Before

Related