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High body weight is one of the risk factors, that can have a significant impact on the course of a coronavirus infection. Several recent studies show increased risks for hospital stays, invasive mechanical ventilation, as well as a higher mortality risk. Weight loss induced by lifestyle changes and increased physical activity can help lower the risk of a severe course of the disease.

Since the beginning of 2020, the new coronavirus named SARS-CoV-2 (Severe Acute Respiratory Syndrome) has been determining the everyday life of peopleall over the world. The virus is transmitted by droplet infection and initiates a disease called Covid-19, which can progress to severe illness with respiratory problems and pneumonia.

There are large differences in the course of the disease between young and old, which are clearly reflected in the death rate. According to the Robert Koch Institute (RKI), 90 % of the deceased in Germany were older than 70 years. High risk patients are elderly people and those with different pre-existing conditions, like cardiovascular disease, diabetes, and chronicdiseases of the respiratory system, the liver, or the kidneys, as well as cancer, and obesity. Obesity is described as severe overweight, that goes significantly beyond what is considered a healthy weight for a given height. The body mass index (BMI) is a measure of body fat based on height and weight. A person with a BMI between 25 and 29.9 kg/m² is classified as overweight and anyone with a BMI over 30 kg/m² is classified as obese. Obesity itself can be classified into 3 grades. A BMI between 30 and 34,9 kg/m² is classified as grade 1 obesity, a BMI between 35 and 39,9 kg/m² as grade 2 obesity and a
BMI greater than 40 kg/m² as grade 3 obesity. Overweight often entails a series of comorbidities. It is therefore not surprising that more and more studies show a correlation between high body weight and a critical course of Covid-19 disease.

Severe disease courses and overweight
In 2018 American researchers at the University of Michigan were able to find a correlation between the duration of influenza A virus shedding and high bodyweight. Obese participants of the study shed the virus 42 times longer than non-obese, even with asymptomatic or mild courses of disease, and were therefore infectious for a longer period.

Additionally, they observed that the course of disease during a viral infection was more severe in overweight people compared to people of normal weight. The study also shows that overweight patients with an influenza infection have a significant higher risk of being hospitalized.

[1]These findings could also be confirmed in recent coronavirusstudies. A current study with 3,615 test subjects from New York that tested positive for Covid-19 shows that patients younger than 60 years of age and with obesity grade 1 are twice as likely to receive treatment in the intensive care unit compared to those of normal weight. Patients with grade 2 obesity under the age of 60 even have a 3.6 times
higher risk.

[2]These studies show, that regardless of age, obesity has a significant impact on the disease course, which means, that younger people can also belong to the risk group. A French research group also showed that the frequency of invasive mechanical ventilation (IMV) increases with increasing BMI. Up to 85 % of all patients with a BMI greater than 35 kg/m² need an IMV.[3]There are different possible reasons for the association of high BMI and severe course of disease.