Cleveland, OH

Obese COVID-19 survivors at risk of long-term complications, study finds

Paul Krasinic

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CLEVELAND — A study from the Cleveland Clinic, published online in the Journal of Diabetes, Obesity, and Metabolism, reveals that survivors of COVID-19 who have moderate even severe obesity may have a greater risk of having long-term consequences of the disease.

Various studies have linked obesity as a factor for establishing a severe form of COVID-19 that may require intensive care, ventilator support, and hospital admission at the beginning stage of the disease. Obesity, a complicated condition caused by multiple factors, is associated with an increased risk for blood clots, cardiovascular disease, and lung conditions.

Obesity reduces the immune system and generates a chronic inflammatory state. Those conditions can lead to less than favorable results after infection with SARS-CoV-2, the primary cause of COVID-19.

“To our knowledge, this current study for the first time suggests that patients with moderate to severe obesity are at a greater risk of developing long-term complications of COVID-19 beyond the acute phase,” said the director of Cleveland Clinic’s Bariatric & Metabolic Institute and principal investigator of the research, Ali Aminian, M.D.

In this observational investigation from March 2020 to July 2020 with follow-up until January 2021, researchers used an enrollment of patients who tested positive for SARS-CoV-2 infection within the Cleveland Clinic health system.

Researchers studied three signs of possible long-term consequences of COVID-19: hospital admission, mortality, and need for diagnostic medical tests - that occurred 30 days or later following the first positive test for the virus.

The results were compared and contrasted among five groups of patients based on their body mass index (BMI): someone classified as having a BMI of 30 or higher has obesity. Someone with a BMI below that is considered normal (18.5-24.9) or overweight (25-29.9).

A total of 2,839 patients who survived the acute phase of COVID-19 and did not need ICU admission were added in this study’s final results. The normal BMI group was considered as a benchmark.

The study discovered that a health problem called post-acute sequelae of SARS-CoV-2 infection (PASC) is a pervasive problem in COVID-19 survivors.

Notably, during a 10-month follow-up after the acute phase of COVID-19, 44% of the study participants had required hospital admission, and 1% died. Additionally, results prove that the risk of hospital admission was 28% and 30% higher in patients with moderate and severe obesity than patients with normal BMI, respectively. The need for diagnostic tests to evaluate different medical problems was 25% and 39% higher in patients with moderate and severe obesity than patients with normal BMI.

The need for diagnostic tests to assess cardiac, gastrointestinal, mental, pulmonary, renal, and vascular health problems was also noticeably higher in patients with a BMI of 35 or above compared to patients with normal BMI.

Future studies are planned to verify the results of this study that obesity is a considerable risk factor for the development of PASC and determine the detailed and long-term follow-up that patients with obesity need after infection of SARS-CoV-2.

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