A new study, released as a preprint in the Lancet, has found that obesity is one of the three greatest risk factors for suffering the most serious consequences of Covid-19, including age. The study give us insight into why Covid-19 has a more serious consequence for the obese and overweight. Fat cells express the receptor for SARS-CoV-2, serving as a reservoir for virus infection. Those who are overweight and obese remain infected several days longer than their aged-matched leaner counterparts. Moreover, obesity creates an underlying inflammatory condition, one that very likely exacerbates the inflammation caused by SARS-C0V-2 infection, one of the leading causes of Covid-19 disease.
This is particularly troubling news for those of us here in the United States, where 42% of Americans are obese and 32.5% are overweight. Obesity is not confined to adults. A total of 13.7 million American children and adolescents are obese—13.9% of children ages 2-5, 18.4% ages 6-11, and 20.6% ages 12-19. The American obesity epidemic coupled with the Covid-19 pandemic is a double disaster. More than two-thirds of adult Americans are at higher risk than average of falling ill when infected by SARS-CoV-2. Since January 2020, close to 900,000 children 0-17 are known to have been infected.
Latin America has been hit with a twofold blow as well. The region has some of the highest Covid-19 death rates in the world and equally distressing levels of obesity and diabetes. In Mexico and Chile, more than 75% of the female population is overweight. Though research on the subject has been relatively limited, there are studies which suggest that obesity, combined with undernutrition, are closely tied to the large number of deaths and severe disease in the region.
Those who favor letting the virus take its natural course in the young and the so-called “low-risk” groups fail to consider the millions of people who fall into a high-risk group simply because of their weight. They often argue that letting the virus infect a low-risk group while protecting those at higher risk is a recipe for what they call “herd immunity”. Not only is this flawed—the data suggest infection does not confer long-lasting immunity—but the low-risk group they point to comprises well less than one-third of the overall population in America and, in some populations and regions like Latin America, numbers that are far lower.
Today we suffer the consequence of government policies at the federal and state level that mitigate our control of the virus. Mandating mask-wearing, limiting the size of crowds, recommending social distancing, and closing bars, all shown to be effective in the control of the disease. It is no wonder that we are witnessing an ever-increasing deluge of patients in our hospitals throughout the country and a rapidly rising death toll, a toll that may well exceed one million dead in the coming year unless we change course quickly.