Long, J. D., Ward, C. A., &amp; Khorasani-Zadeh, A. (2020). The Impact of Obesity on COVID-19 Disease Severity. PRiMER, 4. doi:10.22454/primer.2020.104798

The Impact of Obesity on COVID-19 Disease Severity

Research indicates a positive correlation between body mass index (BMI) and COVID-19 severity. Patients with obesity (BMI ≥ 30) have a higher rate of hospitalization compared to individuals in the normal weight range. Specifically, patients with extreme obesity (BMI ≥ 40) face a very high risk of hospitalization and severe symptoms. Implementing daily exercise, as recommended by a primary care provider, may help lessen these risks for vulnerable patients.

University of California, Davis

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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

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.

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