In a study from University College London, scientists found that high body mass index (BMI), rather than high blood sugar levels, are associated with excess risks of COVID-19 infection and long COVID.
Previous research showed that people with diabetes and obesity are more likely to become severely ill and die if they catch COVID-19, but are no more likely to contract it.
However, the underlying mechanisms, and their role in prolonged post-COVID-19 symptoms (long COVID), remains unclear.
In the study, the team did a meta-analysis of over 30,000 UK adults from nine large studies.
They looked for associations between a range of clinical characteristics measured before the pandemic—HbA1c (average blood sugar level), self-reported or medication-based diabetes, body mass index (BMI) and waist-to-hip ratio (WHR)—and self-reported COVID-19 infection and long COVID.
Between May 2020 and September 2021, 5,806 participants reported ever having COVID-19, and 584 reported having long COVID (around 7% of COVID-19 cases with information on symptoms length).
The team found that higher BMI was linked to greater odds of COVID-19 infection—with the risk 7% higher for each 5kg/m2 increase in BMI.
People with overweight (BMI 25-29.9kg/m2) and obesity (30 kg/m2 or greater) had 10% and 16% greater odds of COVID-19 infection, respectively, than healthy weight people (less than 25 kg/m2.
Similar results were found for long COVID (4,243 participants, six studies)—with the risk 20% higher for each 5kg/m2 increase in BMI.
People with overweight and obesity had 20% and 36% greater odds of long COVID, respectively.
However, for both COVID infection and long COVID links to categories of BMI were not all strong.
Notably, studies focusing on average blood sugar level (HbA1c) and diabetes (15,795 participants and 1,917 for long COVID) found no association with COVID-19 or long-COVID.
The researchers stress the need for further research to explore the mechanisms underpinning these associations and to reduce the excess risk associated with high BMI.
If you care about Long COVID, please read studies that lung damage may persist long after COVID-19 infection, and doctors explain the mystery of long COVID.
For more information about COVID, please see recent studies that many people with long COVID get memory problems, and results showing this drug may relieve painful ‘long covid’ symptoms.
The study was conducted by Dr. Anika Knuppel et al and presented at the European Association for the Study of Diabetes (EASD) Annual Meeting.
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