Coronavirus Chronicles — Another Deep Dive Into Obesity Plus COVID

Research published in the summer of 2021 showed something about obese people — yes, even the moderately obese — who catch COVID and survive. Compared to less weighty people, the obese are more likely to get PASC, also known as post-acute sequelae of SARS-CoV-2., or Long COVID.

The Cleveland Clinic study, originally published in Diabetes, Obesity and Metabolism, looked at a group of 2,839 patients who “did not require ICU admission and survived the acute phase of COVID-19.” Their likelihood of requiring hospitalization, if moderately obese, was 28% higher than healthy weight patients, and if severely obese, was 30% higher. The report said,

Obesity […] is associated with an increased risk for cardiovascular disease, blood clots and lung conditions. In addition, obesity weakens the immune system and creates a chronic inflammatory state. Those conditions can lead to poor outcomes after an infection…

During the followup period after their COVID was no longer acute, “those with obesity were more likely to require diagnostic tests for the heart, lung, and kidney; for gastrointestinal or hormonal symptoms; or blood disorders; and for mental health problems.” However, obesity was not explicitly associated with a higher death rate during that period. As always, the authors called for further studies.

“To our knowledge, this current study for the first time suggests that patients with moderate to severe obesity are at a greater risk of developing long-term complications of COVID-19 beyond the acute phase,” said Ali Aminian, M.D., principal investigator of the research.

Two of the other Cleveland Clinic study authors, Bartolome Burguera, M.D., Chair of the Endocrinology and Metabolism Institute, and Kristin Englund, M.D., the infectious disease physician who leads the center for Long COVID patients, were interviewed. Erin Michael of asked about the reasons for elevated risk. Dr. Burguera described obesity as a “pro-inflammatory and pro-thrombotic disease” whose underlying causes include hyper-inflammation, immune dysfunction, and comorbidities. He added,

Those conditions can lead to poor outcomes in the acute phase of COVID-19 in patients with obesity and could possibly lead to an increased risk for long-term complications of COVID-19 in this patient population.

Dr. Englund made a point with important implications:

As we learn more about who is most at risk for PASC, we can hopefully start to decrease the number of people who develop PASC by focusing on prevention.

These are matters that most people probably do not consider. The virus is not just a problem that causes death, bereavement, and multi-million-dollar hospital bills. It is also a problem that sentences a certain number of people to an undetermined number of years suffering from a condition that manifests itself in at least 100 ways.

It’s a whole bunch of people who will need entire teams of specialists to figure out what is wrong with them and how to fix it. Many of those condemned patients are children today, and some are even obese children, whose futures are at a whole lot of risk.

Your responses and feedback are welcome!

Source: “Association of obesity with postacute sequelae of COVID-19,”, 06/01/21
Source: “Obesity may increase risk of long-term complications of COVID-19, study shows,”, 06/03/21
Source: “Obesity Increases Risk of Long-COVID, Study Finds,”, 06/08/21
Source: “Long COVID-19 among patients with obesity ‘may be missed or misdiagnosed’,”, 09/17/21
Image by Dunk/CC BY 2.0

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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