Covid risk groups: why the overweight and diabetics are so at risk

It is an aspect that makes dealing with Covid-19 so difficult: infections with the SARS-CoV-2 coronavirus affect some people much more than others.

According to previous experience, they are particularly threatening for people who are very overweight and those with diabetes – disorders that are partly mutually dependent and therefore often occur hand in hand.

So far, however, it has been unclear whether a loss of excess pounds and an improvement in the derailed sugar balance can protect those affected from a severe course of Covid-19.

The results of a study by researchers led by Ali Aminian and Steven Nissen from the Cleveland Clinic in Ohio, published in "JAMA Surgery", suggest that this is indeed the case. It included data from more than 20,000 younger men and women treated for severe obesity between 2004 and 2017 at the Cleveland Clinic in Ohio. Around a quarter of the patients had undergone obesity surgery at the time and lost an average of twenty kilograms as a result. The other obese patients had been cared for in the usual way and served as a comparison. On average, their weight had only decreased by about two and a half kilograms. At the beginning of the Corona crisis, these patients therefore weighed significantly more pounds than those people whowho have had a gastric bypass or gastric sleeve.

Weight reduction lowers risk of serious illness

As might be expected, the health benefits of obesity surgery became apparent long before the current pandemic.

In addition to their beneficial impact on excess pounds, weight-loss interventions also reduced elevated blood sugar levels and excess mortality in obese men and women.

In this collective, around five percent of the patients died within ten years and in the other ten percent, i.e. twice as high a proportion.

The operated patients also survived infections with SARS-CoV-2 noticeably better.

The infection rate was just as high for them as for the comparison persons.

It was nine percent between March 2020 and March 2021.

However, obese people who had gastric bypass or gastric sleeves suffered less severe complications – albeit more frequently than healthy people of normal weight.

For example, 15 to 16 percent of the operated patients had to be treated in hospital, and around 22 percent required oxygen therapy;

in a total of nine percent of them, the infection was also severe and fatal in one percent.

The proportion of those affected in the comparison group was much larger, in each case about twice as high.