Obesity puts you at greater risk of serious illness from Covid-19

Obesity puts you at greater risk of serious illness from Covid-19

Anne Dixon, a Vermont pulmonologist, vividly recalls the early days of the Covid-19 pandemic, recalling one particularly shocking patient death.

“We had someone who was very young, had obesity and died of Covid. He was pretty devastating,” she said Dixonprofessor of medicine at the University of Vermont Medical Center.

It was a wake-up call that the pandemic was going to be worse for people living with obesity and Education they have since shown that obesity is associated with a higher risk of severe Covid. Severe covid means cases that require hospitalization, ICU admission, and use of a ventilator. People living with obesity also have a higher risk of Covid-related death.

“Even here in Vermont, which is a relatively lean state compared to many others, we’ve seen people with obesity enter and die in our ICUs,” said Dixon, who researches the effect of obesity on lung health. “We analyzed our data and found that people admitted to our ICU were much more likely to (suffer from obesity) than people who were only admitted to the regular medical plan.”

The Covid pandemic has killed more than 1.1 million people in the United States since 2020, and while the declaration of a public health emergency has ended, Covid continues to be dangerous for many people, including those living with obesity.

Watch: Ask the Expert: Covid-19 and Obesity >>

What is Obesity?

Obesity is a disease in which an excessive amount of body fat results in a body mass index (BMI) of 30 or more. Conversely, people in a “healthy weight range” generally have a BMI between 18.5 and 24.9.

In 1990, about 1 in 10 American adults were obese. Today, 4 out of 10 adults live with obesity One study estimates that by 2030, half of all American adults will have obesity.

“It’s your mother, it’s your sister, it’s your brother, it’s your daughter — the prevalence is so high in our country,” she said Loretta Lee, PhD, RNco-chair of the Nurse’s Obesity Network and associate professor of family, community, and health systems at the University of Alabama at the Birmingham School of Nursing.

How obesity puts people at risk of serious Covid illness

Obesity can have a negative effect on nearly every system in the body, from the cardiovascular (heart) and endocrine (hormones) systems to mental health.

“If a person is diagnosed with obesity, virtually any chronic condition they have will likely get worse…because obesity is linked to impaired immune function,” Lee said. “That’s why people with obesity have worse outcomes from Covid than people who don’t live with obesity.”

People living with obesity are more likely to have other diseases – such as heart disease, lung disease and diabetes – which are risk factors for serious complications from Covid. Also, people with obesity are more likely to have lower lung capacity, putting them at risk for respiratory and more serious illnesses. For example, people with obesity are hospitalized for asthma-related complications a 5 times the rate of people without obesity.

“If your lungs are already a little compromised and your immune system isn’t functioning as well, the combined effects can be absolutely disastrous,” Dixon said.

Covid attacks the lining of the lungs. While most people have mild symptoms of Covid, people with obesity often have a more serious response to the virus, leading to serious outcomes such as organ damage, mental and physical impairments, and long-term Covid caused by inflammation over time, Lee said.

A recent study of Stanford University has discovered that SARS-CoV-2, the virus that causes Covid, attacks adipose tissue. The virus then makes copies of itself in fat cells and causes further infections in other cells. Adipose tissue contains macrophages, immune cells that alert the body to threats and attack them. When these immune cells become infected with the virus, they become inflamed and cause other nearby cells to become inflamed.

One of the authors of the study, Catherine Blish, MD, Ph.D., a professor of infectious diseases at Stanford University, explained that macrophages release proteins that tell other cells that there is a threat. Those cells then attract other inflammatory cells.

Why is this a problem for people with obesity? One theory is that people with obesity have more fat tissue and therefore are more susceptible to this spread of Covid-induced inflammation, although this hasn’t been proven. But, Blish said we know that adipose tissue in people with obesity already has extra inflammation to begin with, so the inflammatory response to the virus could be more severe than in people who don’t have obesity.

“Adipose tissue also lines many of our vital organs, such as our hearts around our intestines. Having inflamed fat right next to your heart is really not an ideal situation,” Blish said.

How to protect yourself from Covid if you live with obesity

Covid is still a real threat to people with obesity. Wearing a mask when out in public can reduce the chances of contracting the virus.

But, by far, the best way to protect yourself is the vaccine. Getting vaccinated can greatly reduce your chances of contracting severe Covid, being hospitalized or dying from Covid.

“I would certainly advise people with obesity to get vaccinated against Covid. This is our best defense” Dixon said.

If you are immunocompromised, you may consider additional doses of the vaccine for added protection. You should also make sure you act quickly if you experience symptoms of Covid and/or test positive. Call your doctor right away and ask him if you’re a good candidate for treatment.

Also, make sure you stay updated on the The latest Covid vaccine guidelines from the CDC and talk to your doctor about your personal situation.

“In addition to getting the vaccine, try to build a healthy lifestyle,” Lee advised. This includes adding more fresh vegetables to your diet, cutting down on processed foods, and making exercise a part of your daily routine. While lifestyle may not be the cause of obesity or a quick fix, healthier choices, coupled with your vaccine, can help you avoid the worst Covid outcomes.

If you live with obesity and think you may have Covid, contact your doctor right away.

This resource was created with support from Pfizer.

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