With the increasing spread of the COVID-19 virus, it is uncertain if the public understands how excess weight can have a negative effect on the clinical course of individuals who are infected with the virus. Excess weight, especially when it results in obesity, is a significant negative factor in how a person’s body deals with a COVID-19 infection. A recent article from the medical journal Lancet, July 17, 2020, reported: “Many reports have linked obesity to more severe COVID-19 illness and death.” Some of the reasons for this situation were given as:
1) Obesity causes a detrimental restrictive ventilatory effect by an increased amount of abdominal (belly) fat. In essence, the increased pressure from the heavy abdominal fat mass limits the lung’s ability to fully expand and take in oxygen. In a French study obese patient were admitted to an ICU with COVID-19 more than seven (7) times the rate of normal weight individuals.
2) Obesity is a prothrombin condition that causes increased blood clotting that is thought to impair lung performance and oxygen transfer in the lungs. Obesity also is a significant risk factor for the development of deep vein blood clots that can lead to pulmonary embolism.
3) Obesity is associated with immune dysregulation and chronic inflammation that could mediate progression toward organ failure in severe COVID-19 infected patients.
4) Patients with obesity are often less physically active and have more insulin resistance which can lead to an increased inflammatory response in the lungs with an increased risk for pulmonary fibrosis in patients infected with the COVID-19 virus. This means less oxygen transfer in the lung
5) Obesity is especially detrimental to lung tissue because fat cells, which are also in lung tissue, secret the hormone Leptin which increases the inflammatory process while also decreasing the release of the anti-inflammatory hormone Adiponectin. This promotes an increase in an inflammatory process in the supporting cells that support lung cells that results in a scarring process-pulmonary fibrosis- that reduces oxygen transfer in lung cells. Research also suggests that fat cells can serve as a harbor to allow the COVID-19 virus to shelter in.
These are some of the medical changes that can occur when infected with the virus, and to some degree these problems can be limited with weight loss. Peter Vash, MD, MPH