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Many of the sickest COVID-19 patients have been obese, according to lots of studies conducted since the whole thing started. That link has become more obvious, with population studies that have confirmed the link.   Even people who are simply overweight are at higher risk. A multinational team of researchers, for example, studied data from many publications that includes 399,000 patients in the first meta-analysis of its sort.1 Obese people are 113 percent more likely need hospitalization, 74 percent more likely to require admittance to the ICU, and 48 percent will die after following contraction of SARS-CoV-2.  In short, it is known that obesity and immune function don’t go together and COVID isn’t helping.

Obesity and immune function with COVID

Those disturbing figures are the combination of biology and society. Obesity’s biology includes lowered immunity, persistent inflammation, and clotting-prone blood, all of which can make COVID-19 worse. Furthermore, because there is often a stigma with obesity, persons who are obese may delay seeking medical help.  In addition, obese people are more likely than normal-weight people to have other conditions, such as heart disease, lung disease, and diabetes.  All of these, even without obesity, are risk factors for severe COVID-19. These folks are also at risk for metabolic syndrome, a condition in which blood sugar, fat, or both are unhealthy, and blood pressure is high.

A recent Tulane University research of 287 COVID-19 patients in the hospital showed that those with metabolic syndrome had a much higher chance of ICU admission, ventilation, and mortality.The largest descriptive analysis of hospitalized COVID-19 patients in the United States, published as a preprint last month by Genentech researchers, found that 77 percent of over 17,000 COVID-19 patients were overweight (29 percent) or obese (48 percent).3

How Obesity makes lung function worse

It isn’t just that obesity and immune function are not friends, its also simple mechanics.  Fat in the abdomen pulls up towards the diaphragm, causing that huge muscle beneath the chest cavity to press against the lungs and impede airflow. Because of the reduced lung volume, airways in the lower lobes of the lungs collapse, allowing more blood to enter fhan in the upper lobes.

Other difficulties make things even worse. For starters, obese people’s blood has a higher tendency to clot, which is especially dangerous during an illness that, when severe, peppers the small veins of the lungs with clots on its own. The endothelial cells that line the blood vessels generally prevent blood clotting. However, COVID injuries epithelial cells and causes a clotting response. When you add weight to the equation, the chance of clotting increases dramatically, creating incredibly sticky blood.

Now, add on the fact that obesity lowers immunity, in part because fat cells infiltrate the organs where immune cells are normally found, such as the spleen, bone marrow, and thymus.  In other words, the extra fat is crowding out what would normally be immunological.  Of course, less immune tissue means less immune response.

Now let’s throw inflammation into the mix!

Obese people also suffer from persistent, low-grade inflammation in addition to a weakened immune response to illnesses. Several inflammatory chemical messengers called cytokines are secreted by fat cells, and more are produced by immune cells called macrophages.  These cells sweep in to clean up dead and dying fat cells. The uncontrolled cytokine activity that defines severe COVID-19 could be made worse by these effects. This ends up creating a lot of tissue damage, recruiting too many immune cells, and eliminating healthy cells.

Certain groups are much more likely to be obese and thus die from COVID

The severity of COVID-19 in obese people helps to explain why some groups have suffered disproportionately from the epidemic. Poverty, lack of access to healthy food, lack of health insurance, and poor exercise opportunities, for example, combine to increase the occurrence of obesity.   On top of that, they are less likely to even seek the medical attention they need.

COVID is far less of a concern if you eat right and exercise

The bottom line is that if you are overweight, you are more likely to die of COVID.  So, if this is you, it is time to change your ways and lose some weight.  This is your wakeup call!  Eating better and exercising are the two best things you can do as even some weight loss reduces your risk.  In the meantime, you might want to take extra precautions to avoid getting COVID.