Obesity and the increased risk for COVID-19: mechanisms and nutritional management

Nutr Res Rev. 2021 Dec;34(2):209-221. doi: 10.1017/S095442242000027X. Epub 2020 Nov 13.


The global COVID-19 (coronavirus disease 2019) pandemic has become a complex problem that overlaps with a growing public health problem, obesity. Obesity alters different components of the innate and adaptive immune responses, creating a chronic and low-grade state of inflammation. Nutritional status is closely related to a better or worse prognosis of viral infections. Excess weight has been recognised as a risk factor for COVID-19 complications. In addition to the direct risk, obesity triggers other diseases such as diabetes and hypertension, increasing the risk of severe COVID-19. The present review explains the diets that induce obesity and the importance of different foods in this process. We also review tissue disruption in obesity, leading to impaired immune responses and the possible mechanisms by which obesity and its co-morbidities increase COVID-19 morbidity and mortality. Nutritional strategies that support the immune system in patients with obesity and with COVID-19 are also discussed in light of the available data, considering the severity of the infection. The discussions held may contribute to combating this global emergency and planning specific public health policy.

Keywords: Coronavirus; Immunity; Nutritional status; Overweight; SARS-CoV-2; Viral infection.

Publication types

  • Review

MeSH terms

  • COVID-19*
  • Diet
  • Humans
  • Obesity / epidemiology
  • Pandemics
  • SARS-CoV-2