Physicians and researchers are noting a troubling trend among the more than 400,000 Americans who have been hospitalized with COVID-19 since the start of the pandemic: Many of them have obesity.
The disease, which has become increasingly prevalent in the last two decades and now affects around 42 percent of adults in the United States, is doing more than showing up as a common characteristic on patient charts. A number of studies have found that obesity, in and of itself, increases risk for hospitalization and intensive-care admissions among COVID-19 patients. (Obesity is defined as a body mass index, or BMI, of 30 or greater.)
It is also associated with a higher risk for death, especially in men and people under 60, according to research recently published in Annals of Internal Medicine. Even overweight adults (people who have a BMI between 25 and 30) may be at increased risk for severe illness from COVID-19, according to recent updates from the Centers for Disease Control and Prevention (CDC).
"This is a unique confluence,” says David Kass, M.D., a cardiologist and professor of cardiology and medicine at Johns Hopkins Medicine. “We happen to have a pandemic of obesity, and we've never had a pandemic of obesity. And the last time we had a virus like this was in the early 20th century [with the Spanish flu].”
Experts are still studying the dangers that can arise when the two pandemics — obesity and COVID-19 — collide, but are gaining a better understanding of why obesity makes a coronavirus infection so dangerous.
Obesity, like COVID-19, can worsen breathing
Obesity is a risk factor for a number of underlying health conditions that are known to complicate a coronavirus infection, including diabetes, heart disease and high blood pressure. But it can also cause damage on its own.
For starters, people with obesity have a harder time breathing — and that's because excess weight, especially around the abdomen area, restricts the movement of the diaphragm, making it more difficult for the lungs to expand and fill with air, explains Fatima Cody Stanford, M.D., an obesity medicine physician at Massachusetts General Hospital in Boston.