Obesity and impaired metabolic health in patients with COVID-19

Abstract

Preliminary data suggest that people with obesity are at increased risk of severe COVID-19. However, as data on metabolic parameters (such as BMI and levels of glucose and insulin) in patients with COVID-19 are scarce, increased reporting is needed to improve our understanding of COVID-19 and the care of affected patients.

Fig. 1. Obesity-related comorbidities and mechanisms of a severe course of COVID-19.

Patients with obesity often have respiratory dysfunction, which is characterized by alterations in respiratory mechanisms, increased airway resistance, impaired gas exchange and low lung volume and muscle strength. These individuals are predisposed to hypoventilation-associated pneumonia, pulmonary hypertension and cardiac stress. Obesity is also associated with an increased risk of diabetes mellitus, cardiovascular disease and kidney disease, comorbidities that are considered to result in increased vulnerability to pneumonia-associated organ failures. However, even in the absence of comorbidities of obesity, the presence of hypertension, dyslipidaemia, prediabetes and insulin resistance might predispose individuals to cardiovascular events and increased susceptibility to infection via atherosclerosis, cardiac dysfunction and impaired immune response.