Hungarian virologists claim that obesity significantly increases the risk of Covid-19 death

The comorbidities associated with obesity were found to be correlated with a severe clinical course of COVID-19 and increased mortality. Researchers from the University of Pécs shed light on possible reasons.

An international research team conducted a series of meta‐analyses on the relationship of individuals with obesity and COVID‐19. They used the data of 399,461 diagnosed patients and concluded that

people with obesity who contracted SARS-CoV-2 were 113% more likely to land in the hospital than people of healthy weight, 74% more likely to be admitted to an ICU, and 48% more likely to die.

Obesity can lead to the development of comorbid conditions, which are independent risk factors for severe COVID-19, including hypertension, heart disease, diabetes, and metabolic diseases, Hvg reported. Hungarian virologists identified three main factors that may influence the vaccine response in individuals with obesity:

• Physical pathologies that result in decreased respiratory capacity. Due to obesity, the fat in the abdomen pushes up on the diaphragm, thus reducing the space in the chest cavity and resulting in restricted airflow.
• Abnormalities in coagulation. Obese patients are at high risk for thrombosis since their blood has an increased tendency to clot. This can be considered a serious risk during an infection. Blood vessels are lined with endothelial cells that create a surface on which blood does not clot. Scientists argue that the SARS-CoV-2 virus injures endothelial cells, which respond to the injury by activating the coagulation system.
• Deterioration of the overall capacity of the immune system. Immunity also weakens in people with obesity, mainly because fat cells infiltrate the organs where immune cells are produced and stored, such as the spleen, bone marrow, and thymus.

According to Hungarian virologists, the deterioration of the capacity of the immune system also affects the efficiency of systemic immune cells circulating in the blood. Any imbalance in the T cell subsets or functions is likely to impair the immune response to SARS‐CoV‐2. Animal experiments suggest that T cells do not function well in an obese state. They make fewer molecules that help destroy virus-infected cells, and the corps of “memory” T-cells left behind after an infection is smaller.

Researchers also highlight that people with obesity suffer from chronic, low-grade inflammation. Fat cells secrete several inflammation-triggering molecules that clean up dead and dying fat cells.

A severe COVID-19 infection can trigger an abnormal immune reaction, called “cytokine storm”, in the case of obese people. The uncontrolled and excessive release of pro-inflammatory signalling molecules can cause multisystem organ failure and even death.

Unfortunately, Hungary has the highest proportion of overweight adults in the EU.

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Source: hvg.hu