Excess weight raises risk for several long COVID symptoms

Key takeaways:

• Excess weight and obesity were linked to long COVID symptoms like vertigo and depression.
• Incorporating weight management and mental health support into long COVID care may improve outcomes, a researcher said.

Excess weight and obesity were significantly associated with long COVID-related neurological and neuropsychiatric symptoms, a systematic review and meta-analysis showed.

The findings build upon prior research indicating that people with obesity are at a greater risk for long COVID.

“Our results highlight the importance of identifying individuals at increased risk for persistent post-COVID-19 symptoms,” Débora Barbosa Ronca, MSC, PhD student at University of Brasília in Brazil and visiting scholar at Edith Cowan University, Australia, told Healio. “Timely, tailored interventions are essential for improving recovery and quality of life. These findings could help inform predictive and preventive health care strategies — both for managing long COVID and preparing for future pandemics.”

According to Ronca and colleagues, long COVID-related neurological and neuropsychiatric symptoms “are of particular interest given the higher incidence of nervous system related sequalae’s after post-viral epidemics.”

“Although the COVID-19 pandemic has come under control, the multisystemic nature of this disease and its long-term impacts have yet to be elucidated,” they wrote in PLoS One.

In the current analysis, the researchers assessed 18 studies published before July 2023 and composed of 139,091 adults — 79,050 and 30,694 of whom had excess weight and obesity, respectively.

Adults with excess weight, defined as a BMI over 25 kg/m², were compared with those with normal weight, whereas adults with obesity were compared with those without it.

Of the included studies — which came from 23 countries, Ronca said — 10 were cross-sectional, two had case-control designs, and six involved cohort or retrospective populations.

Ronca and colleagues found that excess weight was associated with headache (OR = 1.23; 95% CI, 1.1-1.37), persistent depression (RR = 1.21; 95% CI, 1.03-1.42), memory issues (RR = 1.43; 95% CI, 1.24-1.65), vertigo (RR = 1.21; 95% CI, 1.04-1.41) and sleep disturbance (RR = 1.31; 95% CI, 1.16-1.48).

Meanwhile, obesity was significantly associated with smell disorder (OR = 1.16; 95% CI, 1.11-1.22), taste disorder (OR = 1.22; 95% CI, 1.08-1.38), numbness (RR = 1.61; 95% CI, 1.46-1.78), persistent headache (OR = 1.45; 95% CI, 1.37-1.53) and vertigo (RR = 1.44; 95% CI, 1.35-1.53).

The researchers wrote that people with overweight often report health complaints like sleepiness and headache, “which can be exacerbated” by long COVID.

“The co-occurrence of these complex conditions can have deleterious effects, impairing people’s daily functioning and increasing the demand on health care systems,” they wrote.

They also suggested that the greater risk for depression may be the result of the persistent concurrent conditions creating “a vicious circle between physical and neuropsychiatric symptoms.”

Ronca and colleagues acknowledged several study limitations, including that “the ability to determine cause and effect relationships” was limited because most of the studies were cross-sectional, they wrote.

They additionally wrote that there was inconsistency among the included studies when it came to naming long COVID symptoms, which “resulted in a relatively low number of studies reporting the same symptom, which also precluded subgroup comparisons between hospitalized and outpatient populations.”

Ronca said that patients with excess weight or obesity “may benefit from closer monitoring and multidisciplinary care.”

“Incorporating concomitant weight management, mental health support and rehabilitation services into post-COVID care plans could play a crucial role in improving patient outcomes,” she told Healio.

Ronca added that further research is warranted “to explore the biological mechanisms underlying these associations — such as chronic inflammation, metabolic dysfunction and the role of adipose tissue as a reservoir for viral spread.”

For more information:

Débora Barbosa Ronca, MSc, can be reached at primarycare@healio.com.