January 18, 2022 | Loma Linda, California, United States | Molly Smith, Loma Linda University News
Researchers have found that COVID-19 patients who are obese struggle more with long-term effects of the infection compared to those with a lower body mass index (BMI). The United States Centers for Disease Control and Prevention (CDC) has determined that obesity increases the risk for hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death.
With data on very sick patients requiring ICU care, Loma Linda University contributed to a recent study of almost 5,000 patients, published in the journal Obesity, which refuted the notion that obese COVID-19 patients die at a higher rate and instead revealed that these individuals struggle more with long-term effects, particularly to the lungs and kidneys.
“Even though our research suggests that obesity is not an independent risk factor for death in COVID-19, we have observed a number of young patients die or do very poorly with the only chronic medical condition being obesity,” H. Bryant Nguyen, director of the medical ICU at Loma Linda University Medical Center, said. Nguyen is also professor and head of the Medicine, Pulmonary & Critical Care Division at Loma Linda University School of Medicine.
Slightly more than half of the observed patients had obesity, defined by a BMI of 30 or higher. A BMI of 25 or higher was not associated with increased likelihood of death, thrombosis, or blood clotting in the lungs but had a greater risk of acute respiratory distress syndrome or acute kidney injury requiring dialysis.
A larger study, published in Clinical Infectious Diseases, included more than 11,000 patients admitted to 245 hospitals across 38 states of the U.S. and also found that patients with obesity had an increased chance of requiring the ventilator, while obesity in itself was not a risk factor for death.
Obesity subjects a person to an impaired immune system and reduced ability to combat disease, Nguyen said. The severe inflammation that results from COVID-19 can cause acute respiratory distress syndrome in patients with the normal weight range, but an already inflamed body can be susceptible to greater damage, resulting in long-term effects.
Nguyen said he hasn’t observed trends relating to underweight COVID-19 patients. It appears that elderly, malnourished patients have outcomes similar to most other diseases or illnesses.
“Whether obesity is a risk factor or not for death remains unclear. But we know that it is not a good condition for patients having COVID-19,” Nguyen said.
Regardless of BMI, unvaccinated patients have the highest admission rate in the ICU across the nation. Nguyen urges those with obesity to get vaccinated and boosted for an extra layer of protection to prevent the possible risk of a bad outcome from COVID-19.