While the relation between obesity and COVID-19 is not fully known, there are emerging studies pointing to obesity as one of the top underlying condition for people aged 60 years old and under who are hospitalised for the coronavirus. Severe obesity reportedly increases the risk of a major COVID-19 complication known as acute respiratory distress syndrome (ARDS). We asked experts to comment on obesity as a risk factor for becoming seriously ill with COVID-19.
EXPERT REACTION
Associate Prof. Dr Chan Yoke Fun, Virologist & Senior Lecturer at the Department of Medical Microbiology, Faculty of Medicine, University of Malaya, said:
“This article has recently highlighted the high prevalence of obesity in COVID-19 patients requiring invasive mechanical ventilation. Obesity (BMI >30 kg/m2) and severe obesity (BMI >35 kg/m2) patients had a high frequency of admission to intensive care. The disease severity is shown to increase with BMI.
“Severe obesity increases the risk of a serious breathing problem called acute respiratory distress syndrome (ARDS), which is a major complication of COVID-19. People living with severe obesity can have comorbidity: cardiovascular disease, diabetes and kidney disease that can increase the risk of severe illness from COVID-19.”
Dr Vinod RMT Balasubramaniam, Virologist & Senior Lecturer at Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, said:
“Scientists are still finding the crosstalk between obesity and severity of COVID-19. But the mechanisms are likely to be multifaceted, particularly since obesity itself is the result of a complex interaction between genetic, hormonal, behavioural, social and environmental factors. In China, where the outbreak began, data from 383 patients showed that having obesity was associated with a 142% higher risk of developing severe pneumonia associated with COVID-19.
“A larger study of over 4,000 patients with COVID-19 in New York City found that severe obesity was a major risk factor for hospitalization, second only to age. In Seattle, a study of critically ill COVID-19 patients made similar findings. This analysis found that 85% of patients with obesity required mechanical ventilation, compared to 64% of patients without the condition. Moreover, 62% of the patients with obesity died of COVID-19, compared with 36% of those without obesity.
“The study points out that people with obesity are more likely to have higher resistance in their airways, lower lung volumes, and weaker respiratory muscles, which are critical in the defence against COVID-19. These factors make an individual more likely to develop pneumonia, and they place additional stress on the heart. Obesity is also associated with diabetes, heart disease, and kidney disease, all of which likewise increase the risk of developing pneumonia. Setting these issues aside, high blood pressure, high cholesterol levels, and prediabetes could make people more susceptible to infection, the authors point out.”
| Disclaimer: These comments were complied to provide journalists with a range of expert perspectives on the subject. The views expressed here are the personal opinions of the experts. They do not necessarily reflect the views of the Science Media Centre or any other organisation unless specifically stated. |
Bionotes of expert
Associate Professor Dr Chan Yoke Fun is a virologist focused on the epidemiology and pathogenesis of enterovirus A71, an emerging virus that causes severe neurological disease. She leads a laboratory with research interests in epidemiology and pathogenesis of emerging viruses such as enterovirus A71, chikungunya, and respiratory viruses. With more than 20 years of research experience, she has over 80 publications, and has been involved in many research programs and grants at both national and international levels. Dr. Chan also served as an Associate Editor of BMC Infectious Diseases and guest editor in PLOS Neglected Tropical Diseases. She has multiple joint publications with collaborators from Asia, Europe, and the USA. Her studies have led to a better understanding of how viruses spread and infect humans.
Dr Vinod RMT Balasubramaniam graduated from Asian Institute of Medicine, Science and Technology (AIMST) majoring in Biotechnology in 2007. During this period, he managed to publish several papers on plant genetic engineering, especially on genetically engineered orchids which have resistance towards fungus. In 2008, he worked as a research assistant with Associate Professor Sharifah Syed Hassan in her newly formed infectious disease laboratory in Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia. He embarked on his PhD course working on the various host cellular genes infected with Avian Influenza Virus H5N1 and their protein-protein interactions with viral genes. Graduated with merit in 2014, he continued to work as a post-doctoral fellow before joining Professor Adolfo Garcia-Sastre’s laboratory in Mount Sinai hospital New York, which is one of the leading Influenza research laboratory in the world. He has co-authored various publications (Cell Host Microbe, Nature Microbiology, Plos Pathogens) on various aspects of host response towards different types of viruses.
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