People with obesity appear at higher risk for developing long COVID: Study

People living with obesity could be at much higher risk of developing lasting complications from COVID-19, often referred to as long COVID, a new study has found.

Researchers used hospital admission, death and the need for diagnostic medical tests that occurred 30 days or more after the first positive coronavirus test as measurements of possible long-term COVID-19 complications, also called post-acute sequelae of COVID-19.

Compared with patients with normal body mass indexes, the risk of hospital admission was 28% higher for those with moderate obesity and 30% higher for those with severe obesity, according to the study published this month in the journal Diabetes, Obesity and Metabolism.

For patients with moderate obesity, the need for diagnostic tests was 25% higher, while the need for those with severe obesity was 39% higher when compared to those without obesity, the study found.

Obesity was not linked with a higher risk of death during the study’s follow-up period.

“To our knowledge, this current study for the first time suggests that patients with moderate to severe obesity are at a greater risk of developing long-term complications of COVID-19 beyond the acute phase,” Dr. Ali Aminian, the study’s lead author and director of Cleveland Clinic’s Bariatric & Metabolic Institute, said in a statement.

Patients with obesity were more likely to need diagnostic tests for gastrointestinal or hormonal symptoms, blood disorders, mental health problems and heart, lung and kidney issues post COVID-19 infection.

The study involved 2,839 patients in the Cleveland Clinic Health System who tested positive for COVID-19 between March and July 2020. The patients also survived the first phase of the disease and did not require ICU admission.

Within 10 months after initial COVID-19 infection, 44% of patients required hospitalization, 43% needed diagnostic tests and 1% had died.

The findings could be explained by the “underlying mechanisms that deteriorate clinical outcomes in acute phase of COVID-19” in patients with obesity such as hyperinflammation, comorbidities and immune dysfunction, the researchers wrote.

“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,” said Dr. Bartolome Burguera, another study researcher and chair of Cleveland Clinic’s Endocrinology and Metabolism Institute.

Milder symptoms of long COVID include fatigue, brain fog, muscle weakness, sleep difficulties and psychological symptoms, but the study did not include information on these symptoms.

Health experts have warned that obesity increases the risk for severe illness from COVID-19. Higher body mass indexes could be linked to an increased risk of hospitalization, intensive care unit admission, invasive mechanical ventilation and death from COVID-19, says the Centers for Disease Control and Prevention.

Nearly a third of adult COVID-19 hospitalizations in the U.S. were attributed to obesity, CDC models estimate, citing data from the start of the pandemic through November.