Study shows obesity may increase risk of long-term complications of Covid-19

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<strong>A Cleveland Clinic study shows that survivors of Covid-19 who have moderate or severe obesity may have a greater risk of experiencing long-term consequences of the disease, compared with patients who do not have obesity. The study was recently published online in the journal of Diabetes, Obesity and Metabolism.<br />
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Multiple studies have identified obesity as a risk factor for developing a severe form of Covid-19 that may require hospital admission, intensive care, and ventilator support in the early phase of the disease. Obesity, which is a complex disease caused by multiple factors, is associated with an increased risk for cardiovascular disease, blood clots and lung conditions. In addition, obesity weakens the immune system and creates a chronic inflammatory state. Those conditions can lead to poor outcomes after an infection with SARS-CoV-2, which is the virus that causes Covid-19.<br />
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“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,” said Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute and principal investigator of the research, on Thursday..</p>
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<img alt="Obesity Covid " src="https://www.indianarrative.com/upload/news/Ali-Aminian.jpg" style="width: 100%; height: 100%;" /></p>
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<em><strong>Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute and principal investigator of the research (Image courtesy: Cleveland Clinic):</strong></em></p>
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In this observational study, researchers used a registry of patients who tested positive for SARS-CoV-2 infection within the Cleveland Clinic health system in a five-month period from March 2020 to July 2020, with follow-up until January 2021.<br />
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Researchers examined three indicators of possible long-term complications of Covid-19 – hospital admission, mortality, and need for diagnostic medical tests – that occurred 30 days or later following the first positive viral test for SARS-CoV-2. The outcomes were compared among five groups of patients based on their body mass index (BMI): 18.5-24.9 (normal), 25-29.9 (overweight), 30-34.9 (mild obesity), 35-39.9 (moderate obesity), and 40 or greater (severe obesity).  Obesity is a disease classified as having a BMI of 30 or greater.<br />
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A total of 2,839 patients who did not require ICU admission and survived the acute phase of Covid-19 were included in the final results of this study. The normal BMI group was considered as a reference.<br />
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The study found that a health condition called post-acute sequelae of SARS-CoV-2 infection (PASC) is an extremely common problem in Covid-19 survivors. Specifically, during a 10-month follow-up after the acute phase of Covid-19, 44% of the study participants had required hospital admission and 1% died. Furthermore, results show that compared with patients with normal BMI, the risk of hospital admission was 28% and 30% higher in patients with moderate and severe obesity, respectively. The need for diagnostic tests to assess different medical problems, compared with patients with normal BMI, was 25% and 39% higher in patients with moderate and severe obesity, respectively.<br />
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More specifically, the need for diagnostic tests to assess cardiac, pulmonary, vascular, renal, gastrointestinal, and mental health problems was significantly higher in patients with a BMI of 35 or greater, compared with normal BMI patients.<br />
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“The observations of this study can possibly be explained by the underlying mechanisms at work in patients who have obesity, such as hyper-inflammation, immune dysfunction, and comorbidities,” said Bartolome Burguera, M.D, Ph.D., chair of Cleveland Clinic’s Endocrinology & Metabolism Institute and co-investigator of the study. “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.”<br />
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Future studies are planned to confirm findings of this study that obesity is a major risk factor for the development of PASC and determine the long-term and rigorous follow-up that patients with obesity need after a SARS-CoV-2 infection.<br />
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Located in Cleveland, Ohio, Cleveland Clinic – now in its centennial year – is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. It was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation.</p>
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(<em>The full study can be found <a href="https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14454?af=R"><strong>here</strong></a>)</em></p>
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