Susceptibility to Long COVID increased by obesity, particularly in women

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Study shows susceptibility to Long COVID increased by obesity, particularly in women. (Photo: Steve Anderson)


By Cam Buchan

More than four years after the onslaught of the pandemic in 2020, COVID-19’s impact is still being felt across the globe.

In Europe, more than 60 per cent of those affected by COVID-19 are experiencing persistent, often severe symptoms months after the acute infection has subsided – a condition known as Long COVID.

While high Body Mass Index (BMI) is one factor that may increase Long COVID risk, there’s no evidence regarding sex in the relationship between BMI and the risk of Long COVID.

Now, a new study by Dr. Sarah Cuschieri, MD, PhD, along with fellow researchers Dr. Saverio Stranges, MD, PhD, and Piotr Wilk, PhD, shows that women are more likely to have Long COVID, regardless of their BMI. Women at the higher end of the BMI spectrum are also at a greater risk compared to their male counterparts.

The researchers from the Department of Epidemiology and Biostatics at Schulich School of Medicine & Dentistry analyzed data collected from surveys of middle-aged and older adults in 27 countries across Europe. The paper was published in the International Journal of Obesity.

We talked to Cuschieri about the research. 

Dr.-Sarah-Cuschieri-200x350.pngDr. Sarah Cuschieri, MD, PhD, adjunct assistant professor, Epidemiology & Biostatistics (Photo supplied)

What prompted this research?

COVID-19 was a global pandemic that effected every country. From the start of the pandemic, it became very clear that some of the individuals infected by COVID-19 were reporting lagging symptoms months after the acute infection had subsided.

A substantial proportion of the world’s population falls within the obese category i.e., Body Mass Index greater than, or equal to 30 kg/m2*. These individuals have been known to be susceptible to a worse COVID-19 infection outcome. Therefore, our research aimed to find out whether these individuals were also more susceptible to Long COVID and whether there was a difference between sexes.

Describe the research methodology?

The project involved gaining access to the SHARE database, which is a European based cross-country survey targeting the adult population from the age of 50 years onwards. These studies have been repeated across several years, including during the pandemic. Then through collaborative work and analyses, we tested our hypothesis by identifying those that reported Long COVID symptoms and linking this to their BMI and their sex.

What did you learn?

Women were more likely to suffer from Long COVID regardless of their BMI status. However, men showed a different relationship. It appears that men at the highest spectrum of the BMI had lower risk of Long COVID. It is important to understand there might be other factors affecting this relationship and one cannot omit the fact that a high BMI predisposes the individuals to develop other chronic diseases.

Why is this information important in understanding Long COVID prevention and treatment?

An understanding of who is more susceptible to Long COVID, including sex differences, allows health-care professionals as well as policy makers to establish a preventive care pathway as well as treatment plans that target at-risk individuals with an anticipated better individual outcome. The study also emphasizes the importance of sex differences when assessing the potential long-erm consequences of Long COVID.

Are further studies planned?

Yes. We are currently planning to continue exploring the susceptibility of Long COVID across different countries and health statuses.

*Calculated from a person’s height and weight and used to indicate whether a person’s weight falls within a healthy range.