Excessive Body Weight Predisposes COVID-19 Complications

New research shows that excessive weight is a main determining factor in who experiences complications from COVID-19 and who doesn’t. COVID-19 complications are heavily defined by respiratory symptoms – specifically acute respiratory failure and acute respiratory distress syndrome – that can be driven by characteristics common in obese individuals, including chronic, low-grade inflammation and hyperventilation (breathing at an abnormally high rate).

A March study conducted across 14 states found that approximately 48.3% of those hospitalized for COVID-19 were obese. A second study found that BMI was strongly associated with the severity of disease; as BMI increased, so did the likelihood of being admitted to critical care. A third study also found that those with obesity were significantly more likely to need mechanical ventilators for care. 

While the respiratory capacity of excessively overweight individuals is compromised, putting them at a greater risk for COVID-19 complications, the underlying inflammation that is ever-present in the obese “environment” also increases susceptibility for severe infection. Chronic inflammation can cause impaired immune function as well as an overactive immune response (or as you may have heard about, the “cytokine storm”) when fighting an infection. This can cause the body to experience more severe symptoms and complications from viral infections like the coronavirus.

If you’re overweight and concerned about your coronavirus risk it’s important to know the specifics and how to protect yourself. The above studies show that those with a BMI of 35 or above have the greatest risk for COVID-19 complications (3.6 times more likely to need critical care), when compared to those with a BMI less than 30, and those with a BMI between 30 and 35 are at a moderate risk of COVID-19 complications (1.8 times more likely to need critical care).

If you are overweight and are wanting to assess your risk, calculating your BMI could be helpful. Use this tool provided by the National Institutes of Health to calculate your BMI. A BMI below 25 is considered healthy, between 25 and 29.9 is considered overweight, and a BMI of 30 or greater is considered obese. Keep in mind that BMI is not, by any means, a perfect predictor for healthy body weight. Those with lots of muscle can have higher BMI’s but not be overweight. If this is you, then veer away from using BMI as a predictor of health, and instead use percent body fat. If you fall near or above 30 for your BMI, you may be at a higher risk of COVID-19 complications, and protecting yourself by consuming healthy foods, getting plenty of sleep, managing your stress, and following the social distancing guidelines outlined by your state can help protect you.