Obesity is an established risk factor for severity of Covid-19 infection as well as mortality. Now, a new Cleveland Clinic study has suggested that patients with obesity are also at greater risk for post-acute sequelae of SARS-CoV-2 infection (PASC), commonly referred to as “long COVID-19”.

The study published in the journal Diabetes, Obesity and Metabolism involved 2839 Covid-19 positive patients from a clinical registry of all patients tested positive by RT-PCR for SARS-CoV-2 infection, within the Cleveland Clinic health system in a five-month period from March 2020 to July 2020, with follow-up until January 2021. These patients had not needed intensive care for their illness and had survived the acute infection. 

Three parameters were assessed namely hospital admission, need for diagnostic medical tests and death occurring ≥30 days after the first confirmatory test. Patients were categorised into five groups based on their body mass index (BMI): 18.5-24.9 (normal), 25-29.9 (overweight), 30-34.9 (mild obesity), 35-39.9 (moderate obesity), and ≥40 (severe obesity). 

• During the follow up of 10 months, 44% of patients had to be hospitalized; one percent of patients died during this time.
• The risk of hospital admission was 28% higher in patients with moderate obesity and 30% higher in those with severe obesity vs patients with normal BMI.
• The need for diagnostic tests for various medical problems post-infection was found to be 25% and 39% higher in patients with moderate and severe obesity, respectively.
• Compared to patients with normal BMI, those with BMI ≥35 were more likely to require diagnostic tests to evaluate for cardiac, pulmonary, vascular, renal, gastrointestinal, and mental health problems.

Although more studies need to be done to confirm these findings, this study does show that obesity just does not have an effect on the severity of infection; it also increases the risk for long-term complications of Covid-19 as evident by the fact that up to 44% of the patients required hospital admission during the follow up period after the initial infection.

(Source: Obesity increases risk for long-COVID, study finds - Medscape - Jun 08, 2021; Cleveland Clinic News Release, June 3, 2021)