Why COVID-19 is more deadly in people with obesity—even if they’re young
By Meredith WadmanSep. 8, 2020 , 6:00 PM
Science’s COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

This spring, after days of flulike symptoms and fever, a man arrived at the emergency room at the University of Vermont Medical Center. He was young—in his late 30s—and adored his wife and small children. And he had been healthy, logging endless hours running his own small business, except for one thing: He had severe obesity. Now, he had tested positive for COVID-19 and was increasingly short of breath.

He was admitted directly to the intensive care unit (ICU) and was on a ventilator within hours. Two weeks later, he died.

He was a young, healthy, hardworking guy,” recalls MaryEllen Antkowiak, a pulmonary critical care physician who is medical director of the hospital’s ICU. “His major risk factor for getting this sick was obesity.

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People with obesity should take extra care to avoid getting sick, Messaoudi says. “If you are a person with obesity, be extra, extra cautious,” she says. “Wear your mask. Wash your hands. Avoid large gatherings.”

In addition, exercising and, separately, losing even a little weight can improve the metabolic health of a person with obesity, and, in doing so, reduce their chances of developing severe COVID-19 if they become infected, says Stephen O’Rahilly, a physician-scientist who directs the MRC Metabolic Diseases Unit at the University of Cambridge. “If you’re 300 pounds, even losing a modest amount is likely to have a disproportionate benefit on how well you do with coronavirus infection. You don’t have to become a slim Jim to benefit.”