COVID-19 and Obesity

This page will be updated as new information becomes available. Last update: 10.24.20

The novel Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has created a global pandemic with its syndrome, COVID-19. The number of people affected by COVID-19 continues to increase worldwide, and information about risk factors for severe COVID-19 and mortality is emerging almost daily.

Older adults and those who are immunocompromised due to underlying medical conditions are at higher risk for developing serious complications from COVID-19 illness. For both young and old adults, emerging data suggests that obesity may be linked to risk of severe illness and hospitalization. [1,2] A recent systematic review of 75 studies found that compared to people of healthy weight, individuals with obesity were 113% more likely to be hospitalized, 74% more likely to be admitted to the intensive care unit, and 48% more likely to die. [3] The review incorporated earlier research looking at obesity and COVID-19, including:

  • A study in France which showed that the risk for needing ventilators in patients with COVID-19 was more than 7-fold higher for individuals with a body mass index (BMI) above 35, compared to those with a BMI less than 25. [4]
  • A study in New York City which found people younger than 60 years of age with a BMI above 30 were significantly more likely to be admitted to care than individuals with a BMI less than 30. [2]
  • Additional research from New York City demonstrating that patients with obesity had significantly higher rates of admission to intensive care units or rates of death. [5]
  • A study In Mexico where COVID-19 patients with obesity had higher rates of admissions to intensive care units, were more likely to be intubated, and had a five-fold increased risk for mortality. [6]

Why might people with obesity be more at risk for severe illness from COVID-19?

Currently, the mechanisms responsible for greater COVID-19 severity in individuals with obesity are unknown. However, insights from other viral infections like influenza point to potential issues including reduced immune function, chronic systemic inflammation, metabolic dysfunction, and reduced pulmonary function. [3] Also, people with obesity are more likely to have other diseases that are risk factors for severe COVID-19, including type 2 diabetes, heart disease, kidney/liver disease, and hyperlipidemia. [3,7]

Its also important to note that COVID-19 has disproportionately affected racial/ethnic minority groups in the United States; in particular, Black, Hispanic, and Native American communities. These racial/ethnic minority populations experience higher hospitalization rates, severe illness, morbidity, and mortality from COVID-19. Long-standing systemic health and social inequities have contributed to such disparities, which increase the risk of COVID-19 severity. [8,9]

The pandemic has highlighted several structural shortcomings of our healthcare system, and the need for coordinated federal obesity prevention funding and efforts. COVID-19 has laid bare the devastating impact of the intersection between infectious and chronic disease. Focusing efforts on policies and strategies that target the root causes of obesity and metabolic health, particularly among vulnerable and racial/ethnic minority populations, continue to be as critical as ever.

Keeping yourself healthy during COVID-19

There are some steps that everyone can take to protect their health during COVID-19, including: [10]
  • Practice social distancing, wear masks, and wash your hands often.
  • Ensure that your underlying health conditions are being well-managed with prescribed medications and according to you doctor’s recommendations. Don’t miss important medical appointments, reach out to see if telehealth visits are available, and don’t skip refills on important medications that help manage your conditions.

Although we do not have concrete evidence regarding specific dietary factors that can reduce risk of COVID-19, we do know that eating a healthy diet, being physically active, managing stress, and getting enough sleep support our immune system. Even moderate improvements in nutrition and physical activity may improve metabolic health and reduce the severity of COVID-19 risks.

Visit The Nutrition Source for additional tips and resources