One of the common statements often repeated in the media about COVID-19 is that it is seemingly random in terms of both getting the virus and having a poor outcome. But, upon further inspection, that’s not what the actual science is revealing. As we move deeper into our involvement with this virus some important patterns are emerging that make it quite clear that COVID-19 does indeed discriminate.
In a recent article, Dr. Austin Perlmutter explored how COVID-19 is actually an “opportunistic infection,” meaning that it takes advantage of patients whose immune systems are not functioning optimally. In the past we would have considered less than optimal immune function to be a characteristic of people who have had, for example, chemotherapy or radiation treatment, exposure to immune-suppressing medications after organ transplantation, or a diagnosed autoimmune disease. But as Dr. Austin Perlmutter has made clear, we now need to broaden our scope and embrace the notion that so many of our most common degenerative conditions, from diabetes to obesity, actually compromise immune function and allow the SARS-CoV-2 virus the opportunity to do its dirty work.
We may not have a lot of control over some issues that can threaten immune regulation, like cancer or chemotherapy, but when it comes to things like diabetes, coronary artery disease, and obesity, our lifestyle choices turn out to be highly influential on risk for and risk of progression of these issues. This reality sets the stage for the understanding that, in a very real sense, our lifestyle choices strongly influence our COVID-19 risk.
Let’s look at some statistics that relate obesity, by and large a manifestation of lifestyle choices, to COVID-19 risk. In a study published in Obesity Reviews, researchers at multiple universities and the World Bank used 75 studies to perform a meta-analysis of the relationship of obesity to the spectrum of COVID-19 involvement—from risk to death.
The findings of this report are telling. In comparing obese to non-obese individuals, obesity was associated with a 46% higher risk of being COVID-19 positive, a 113% higher risk of hospitalization, a 74% higher risk for ICU admission, and a 48% increased risk of death from the virus. And the authors made it quite clear that mechanistically, one of the main reasons for these risk metrics related to obesity centers on disruption of immune function, stating:
The immunological impairments from individuals with obesity demonstrate the convergence of chronic and infectious disease risks. They expose a large portion of the world population with overweight/obesity status to greater risk of pulmonary viral infections like COVID-19.
We hopefully await the development of meaningful immunization as well as more effective treatment protocols for this increasingly threatening virus. But it’s important to embrace the notion that we are not powerless when it comes to both our infection risk and outcomes. Our lifestyle choices in areas like diet, sleep, exercise, and dealing with stress all factor into our immune competence and may well deny this coronavirus the notion of opportunism.