The vicious cycle: a history of obesity and COVID-19

Abstract

Recently, we face a surge in the fast-forward Coronavirus Disease 2019 (COVID-19) pandemic with nearly 170 million confirmed cases and almost 3.5 million confirmed deaths at the end of May 2021. Obesity, also known as the pandemic of the 21st century, has been evolving as an adverse prognostic marker. Obesity is associated with a higher risk of being SARS-CoV-2-positive (46%), as well as hospitalization (113%) and death (48%) due to COVID-19. It is especially true for subjects with morbid obesity. Also, observational studies suggest that in the case of COVID-19, no favorable “obesity paradox” is observed. Therefore, it is postulated to introduce a new entity, i.e., coronavirus disease-related cardiometabolic syndrome (CIRCS). In theory, it applies to all stages of COVID-19, i.e., prevention, acute proceedings (from COVID-19 diagnosis to resolution or three months), and long-term outcomes. Consequently, lifestyle changes, glycemic control, and regulation of the renin-angiotensin-aldosterone pathway have crucial implications for preventing and managing subjects with COVID-19. Finally, it is crucial to use cardioprotective drugs such as angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers and statins. Nevertheless, there is the need to conduct prospective studies and registries better to evaluate the issue of obesity in COVID-19 patients.

The assessment of the risk of COVID-19 infection and its course in the medical staff of a COVID-only and a non-COVID hospital

“…24,25 The epidemiology of COVID-19 incidence based on analyses of large populations shows a clear association with body weight, especially with obesity. 26,27 In a study conducted in a group of medical staff employed at both COVID and non-COVID hospitals, BMI values were higher for those who had an infection compared to those who were not infected. Consistent with our studies, Popkin et al found an increased number of COVID-19-positive individuals among obese ones; in addition, individuals with obesity were more likely to be hospitalized.…”

Obesity: A pandemic hidden in the Covid-19 pandemic

“…According to Bil and Możeńska (2021), the relationship between obesity and Covid-19 represents the perfect vicious cycle [4] . A large 2022 meta-analysis of 208 studies involving more than 3,550,000 participants demonstrated that obese subjects are susceptible to threatening Covid-associated complications; obesity is associated with a 72% (95% CI 1.62–1.84) higher risk of hospitalization and 25% (95% CI 1.19–1.32) higher risk of mortality due to Covid-19; severe obesity is associated with a 2.53 (95% CI 1.67–3.84)-fold higher risk of hospitalization and 2.06 (95% CI 1.76–3.00)-fold higher risk of mortality due to Covid-19 [5] .…”