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How obesity contributes to long Covid

Obesity, a known risk factor for many diseases, including Covid-19, also contributes greatly to long-Covid conditions, both by prolonging symptoms as well as increasing its severity, health experts said here.

A growing body of evidence has suggested a link between long Covid and obesity — more than 1 billion people worldwide and about 135 million in India.

Obesity is known to cause lethargy, raise fatigue, shortness of breath, limit range of physical activities — symptoms that are independently present in long Covid, but their significance and severity gets compounded by obesity.

A study published in Scientific Reports, showed that people with extreme obesity with body mass index (BMI) more than 40kg/m2 were identified as independent risk factor for developing long-Covid symptoms.

Even as obesity increased the risk of morbidity and mortality in acute Covid patients, long Covid symptoms also get aggravated in overweight people, said experts. 

“Obesity, defined by excessive body fat accumulation, is associated with chronic low-grade inflammation and impaired immune function. These factors may contribute to prolonged symptoms and increased severity of long Covid in obese individuals,” Dr Arun Prasad, Senior Consultant, GI, Bariatric and Robotic Surgeon, Indraprastha Apollo Hospitals, New Delhi, told IANS.

“Additionally, obesity is known to be a risk factor for various comorbidities, such as cardiovascular disease and diabetes, which can further complicate the recovery process,” he added. 

Long Covid has been defined as both “ongoing symptomatic Covid-19” (symptoms four to 12 weeks after infection) and “post Covid syndrome” (symptoms which continue for 12 weeks or more). 

While the exact numbers of those living with long Covid are uncertain, studies show that around 10-20 per cent of people infected by SARS-CoV-2 may go on to develop symptoms that can be diagnosed as long Covid. And official estimates state that Covid has infected more than 763 million — a number which could be significantly more. 

“The inflammation levels are higher in obese patients, it takes longer for the virus to leave the patient’s body, and overall immunity of obese patients is lower as compared to those with active lifestyle and normal BMI,” Dr. Sakshi Singh, consultant, Dept. of Internal Medicine, Amrita Hospital, Faridabad, told IANS.

“In addition, obesity can negatively impact lung function and oxygenation, impairing respiratory recovery. Moreover, the psychological and emotional toll of obesity, including stress and depression, can further contribute to long-haul symptoms,” added Dr Prasad.

Another study published in the PLOS Global Health revealed that women who are overweight are at the highest risk of developing long Covid.

“Yes, certain studies did show such patterns. It can be because of metabolic and functional effects on sexual hormones, combined with high levels of inflammatory markers,” Dr Singh explained. 

Understanding the link between obesity and long Covid is crucial in tailoring effective treatment strategies and providing appropriate support to individuals, particularly obese women, who may be at higher risk of prolonged illness, the experts said.

There is growing evidence to suggest that weight reduction can have a positive impact on managing long Covid symptoms. 

“Cutting down weight shall help in multiple ways, as it reduces inflammation, boosts physical stamina, respiratory functions, and would allow a person to improve the range of physical motions possible,” Dr Singh said. 

“By losing weight, individuals may experience improvements, potentially alleviating symptoms associated with long Covid, such as fatigue, shortness of breath, and joint pain,” Dr Prasad told IANS. 

“In addition, weight loss can positively influence cardiovascular health, which is particularly important as long Covid has been associated with an increased risk of cardiovascular complications,” he said.

However, the experts stressed the need “to approach weight loss in a healthy and sustainable manner, incorporating a balanced diet, regular physical activity, and professional guidance to ensure overall well-being and optimise the management of long Covid symptoms”.  

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