I often notice the terms underlying or preexisting health conditions pertaining to the severity of COVID-19 infection in media reporting. Rarely are these conditions well defined, but it is vital for the public to know what these risk factors are and to understand that many of these conditions are under their control. 

The real issue is inflammation, which often parallels how much body fat one carries. Fat cells release pro-inflammatory chemicals, which cause a person’s baseline inflammatory state to be elevated. Add an injury or infection to that individual, and their inflammatory state rises further. Blood tests that measure inflammation have been identified in predicting the severity of a COVID-19 infection. For many people, inflammation can be chronically elevated due to reasons such as obesity (body fat). Be aware that it is possible to be overweight and not inflamed, or thin and inflamed. For this reason, I think it is wise for most everyone to have their level of inflammation tested. A low Vitamin D level has also been identified as a factor that can cause a more severe infection.

3 Blood Tests Regarding COVID-19 Severity

  1. C-reactive protein (hs-CRP) inflammation 
  2. Ferritin iron and inflammation
  3. Vitamin D (25-(OH)D) important in immune function

What’s Your Number?

Our immune system has defenses for 2 different types of invasions- one for intracellular and another for extracellular infections. Extracellular would include things such as parasites, foreign objects, larger bacterial cells, etc. This is the part of the immune system that attacks parasites and leads to organ transplant rejections. Intracellular infections include most viruses (including coronaviruses) and smaller bacteria which can invade one’s cells. In severe COVID-19 cases, it has been discovered there is an inappropriate immune response.

In people with properly functioning immune systems, their intracellular defenses are activated, which quickly destroy the virus. These are the majority of COVID-19 infections which result in mild to no symptoms. Yet in some, it’s the extracellular defense that responds, which is far less capable of destroying the SARS-CoV-2 virus. As a result, the virus continues to replicate, which sends more warnings to the immune system, which in turn further escalates its extracellular responses.

Desperate, the immune response becomes so vigorous (called the cytokine storm), it begins to destroy one’s own tissues causing lung damage, blood clots, and possibly death. Having a higher baseline inflammatory state (as often seen in obesity) makes one more susceptible to having this deranged immune response to this particular virus. Patients with just mild obesity have a 2.5 times greater risk of respiratory failure and 5 times greater risk of being admitted to an ICU. Moderate obesity (approx. 70 lb overweight) lends to a 12X greater risk of death from COVID-19.

We’re gaining weight instead of losing it

obesity kills

Knowing this, why has there not been a national campaign to encourage weight loss?! Instead we close down gyms while fast food and liquor stores are thriving. This, along with the added stress caused by our pandemic response, has caused 76% of people to gain weight. This has led to the what many jokingly call the “quarantine 15”.

A True And Tragic Tale

A long-time patient of mine passed away mid-July as a result of this virus. She was an intelligent professional with a great sense of humor. During the pandemic she had been working from home. She was not elderly (same age as me, in fact, which is 49). She was on no prescription medication. She had none of the health issues most think of when they hear “underlying health conditions”. No heart disease, no diabetes, no autoimmune disease, no high blood pressure. She did not die from another cause and “just happened to have COVID-19.” Her family told me the hospital doctors commented that her immune system kept responding inappropriately. The only factors working against her – she was overweight and inflamed

COVID-19 is Here to Stay

Sadly, this virus is here to stay, and we cannot simply hide from this virus forever.  Our future will be determined by how long immunity lasts. In SARS (another type of coronavirus), immunity lasts 2 years, while in other coronaviruses (which cause the common cold) immunity lasts less than a year. So, we can expect COVID-19 outbreaks either every or every other year for the rest of our lives. Does this mean we should isolate ourselves several months every year and wear masks the rest of our lives?


Many are holding out for the vaccine sure to bring salvation and restore us to normality. Bear in mind, scientists have been trying to create a vaccine for the common cold and SARS (both coronaviruses) for many years and have been thus far unsuccessful. The challenge with this type of virus is that to create an antibody response, the viral load has to be high. Weakened (used in the measle vaccine) or inactive (polio vaccine) forms of this virus will not illicit antibody responses. In other words, you must be injected with enough coronavirus to cause a COVID infection in order to make antibodies. 

In the much hailed Moderna vaccine trial, over half reported side effects of fatigue, headache and fever as high as 103.9, and even “influenza-like pneumonia”. In other words, COVID-19. Keep in mind, the volunteers for the study were all healthy and aged 18-55. It is believed that half of healthy people in this age group who become infected naturally with coronavirus have no symptoms while the other half have mild to moderate symptoms. The same results as the vaccine trial. What happens when the unhealthy or elderly get the vaccine? 

The other serious vaccine contender from Pfizer uses a never before used technology that reprograms our genetic code so that our body creates the coronavirus, which then triggers an immune response. The development of this vaccine is being rushed at a concerning “warp speed”. 

Obesity is a Huge Factor

A little known and under-reported fact is that vaccines are far less effective on obese individuals. All experts agree that the same will hold true for any vaccine created for this coronavirus. Some experts even think it will not work at all for those who are obese.  

Facing reality head-on is the best way forward. My intent in bringing you this information is not to shame or discourage, but to issue a wakeup call to get yourself into good shape through diet and exercise. You only have this one body, so take good care of it! 

Test your inflammation levels because higher inflammation means higher risk of severe outcomes. If you would like to know your numbers (inflammation and Vit. D) contact me for low price lab work. If you are ready to improve your health, I’m here to help. We start by scheduling a 30-minute consult. Bring your most recent labs and a 3-day food diary of your usual eating pattern.

Contact our office for an appointment.

Related: Hit the Pool to get rid of that “Quarantine 15”!