Global pandemics interconnected — obesity, impaired metabolic health and COVID-19
Open accessAbstract
Obesity and impaired metabolic health are established risk factors for the non-communicable diseases (NCDs) type 2 diabetes mellitus, cardiovascular disease, neurodegenerative diseases, cancer and nonalcoholic fatty liver disease, otherwise known as metabolic associated fatty liver disease (MAFLD). With the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), obesity and impaired metabolic health also emerged as important determinants of severe coronavirus disease 2019 (COVID-19). Furthermore, novel findings indicate that specifically visceral obesity and characteristics of impaired metabolic health such as hyperglycaemia, hypertension and subclinical inflammation are associated with a high risk of severe COVID-19. In this Review, we highlight how obesity and impaired metabolic health increase complications and mortality in COVID-19. We also summarize the consequences of SARS-CoV-2 infection for organ function and risk of NCDs. In addition, we discuss data indicating that the COVID-19 pandemic could have serious consequences for the obesity epidemic. As obesity and impaired metabolic health are both accelerators and consequences of severe COVID-19, and might adversely influence the efficacy of COVID-19 vaccines, we propose strategies for the prevention and treatment of obesity and impaired metabolic health on a clinical and population level, particularly while the COVID-19 pandemic is present.
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Minority groups like Blacks and Hispanics have higher rates of obesity, poor nutritional status, and chronic disease, which lower immune protection and increase susceptibility to infection.
“These groups also have higher rates of obesity, poor nutritional status, and chronic disease, which lower immune protection and increase susceptibility to infection [38].”
From Relative risk reduction: Misinformative measure in clinical trials and COVID-19 vaccine efficacy (2022) · cites this paper as [38]
The section “Treatment of people with metabolically unhealthy obesity without COVID-19” reports immune changes and reduced influenza-vaccine efficacy in people with obesity or diabetes. The paper also associates obesity with more severe COVID-19, but the passages do not establish that Black and Hispanic groups have higher rates of the listed conditions or poor nutritional status, or that those conditions collectively increase susceptibility to infection. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn obesity, excessive abdominal fat, especially visceral adipose tissue accumulation, increases the risk of metabolic disorders such as type 2 diabetes mellitus, cardiovascular disease, and non-alcoholic fatty liver disease.
“Obesity, and in particular abdominal obesity, increases the risk of several diseases, including type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), non-alcoholic fatty liver disease (NAFLD), polycystic ovarian syndrome (PCOS), severe COVID-19 disease, and certain types of cancer (Kopelman, 2000; Stefan et al., 2021).”
From Effect of Exercise Training on Fat Loss—Energetic Perspectives and the Role of Improved Adipose Tissue Function and Body Fat Distribution (2021) · cites this paper as Stefan et al., 2021
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“Thesegroupsalso havehigherrates of obesity, poornutritionalstatus, and chronic disease, which lower immune protection and increase susceptibility to infection [38].”
- Authors
- Stefan, N., Birkenfeld, A. L., & Schulze, M. B.
- Affiliations
- Helmholtz Munich (DE)
- King's College London (GB)
- University of Potsdam (DE)
- Corresponding author
- Stefan, Norbert
- Venue
- Nature Reviews Endocrinology
- Published
- 2021-01-21
- Volume
- 17
- Issue
- 3
- Pages
- 135-149
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- OpenAlex
- W3122663099
- Cited by
- 452
- References
- 32
- Citations by year
- 2026: 20 · 2025: 27 · 2024: 65 · 2023: 96 · 2022: 151 · 2021: 92 · 2018: 1
- FWCI
- 11.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- publish.UP (University of Potsdam) (submittedVersion)
- Site cant be reached (submittedVersion, other-oa)
- Funders
- Deutsche Forschungsgemeinschaft
- Bundesministerium für Bildung und Forschung
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- obesity, COVID-19 pandemic, SARS-CoV-2, visceral obesity, hyperglycemia, hypertension, subclinical inflammation, metabolic-associated fatty liver disease, non-communicable diseases, type 2 diabetes, cardiovascular disease, COVID-19 vaccine efficacy, obesity prevention and treatment, COVID-19 mortality
- MeSH terms
- COVID-19, SARS-CoV-2, Humans, Obesity, Risk Factors, Pandemics
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