In a new study from Cleveland Clinic, researchers found that survivors of COVID-19 who have moderate or severe obesity may have a greater risk of experiencing long-term consequences of the disease, compared with patients who do not have obesity.
Multiple studies have identified obesity as a risk factor for developing a severe form of COVID-19 that may require hospital admission, intensive care, and ventilator support in the early phase of the disease.
Obesity, which is a complex disease caused by multiple factors, is associated with an increased risk for cardiovascular disease, blood clots and lung conditions.
In addition, obesity weakens the immune system and creates a chronic inflammatory state. Those conditions can lead to poor outcomes after infection with SARS-CoV-2, which is the virus that causes COVID-19.
In this study, researchers used data of 2,839 patients who tested positive for SARS-CoV-2 infection within the Cleveland Clinic health system in a five-month period from March 2020 to July 2020.
The outcomes were compared among five groups of patients based on their body mass index (BMI): 18.5-24.9 (normal), 25-29.9 (overweight), 30-34.9 (mild obesity), 35-39.9 (moderate obesity), and 40 or greater (severe obesity).
Obesity is a disease classified as having a BMI of 30 or greater.
The team found that a health condition called post-acute sequelae of SARS-CoV-2 infection (PASC) is an extremely common problem in COVID-19 survivors.
Specifically, 44% of the study participants had required hospital admission and 1% died.
Compared with patients with normal BMI, the risk of hospital admission was 28% and 30% higher in patients with moderate and severe obesity, respectively.
The need for diagnostic tests to assess different medical problems, compared with patients with normal BMI, was 25% and 39% higher in patients with moderate and severe obesity, respectively.
More specifically, the need for diagnostic tests to assess cardiac, pulmonary, vascular, renal, gastrointestinal, and mental health problems was much higher in patients with a BMI of 35 or greater, compared with normal BMI patients.
The team says the findings may be explained by the underlying mechanisms at work in patients who have obesity, such as hyper-inflammation, immune dysfunction, and comorbidities.
Those conditions can lead to poor outcomes in the acute phase of COVID-19 in patients with obesity and could possibly lead to an increased risk of long-term complications of COVID-19 in this patient population.
The study is published in Diabetes, Obesity and Metabolism. One author of the study is Ali Aminian, M.D.
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