Is Covid-19 associated with acute weight loss and malnutrition? Here’s what you need to know

While there has not been any clear analysis, an October 2020 posthoc analysis of a prospective cohort study stated that “coronavirus disease 2019 may associate with clinical manifestations, ranging from alterations in smell and taste to severe respiratory distress requiring intensive care, that might associate with weight loss and malnutrition”. To understand more about this unintentional weight loss, we reached out to experts.

As per the National Center for Biotechnology Information (NCBI) study, weight loss and risk of malnutrition were “highly prevalent in Covid-19 patients evaluated after clinical remission with nearly 30 per cent of patients losing more than five per cent of baseline body weight, and more than half were at risk of malnutrition”.

Dr Abhishek Subhash, consultant, internal medicine at Bhatia Hospital mentioned that weight loss is being seen in many Covid patients due to loss of smell and taste. “But it can be more drastic with patients who have had mucormycosis infections. This is because loss of smell and taste due to Covid leads to a natural reduction in appetite. With secondary infection of mucormycosis, these patients have had to undergo surgery and were put on high range of anti-fungal medicines which causes nausea, again affecting their appetite, and in many cases leading to weight loss,” he mentioned.

Alterations of smell and taste, as well as fatigue and lack of appetite, are reported as prevalent symptoms in Covid-19 patients that could affect food intake, a 2020 NCBI study says. (Source: Express Photo by Tashi Tobgyal)

Alterations of smell and taste, as well as fatigue and lack of appetite, are reported as prevalent symptoms in Covid-19 patients. “Confinement at home and Covid-19 symptoms may limit the amount of physical activity, leading to loss of lean mass. These factors, on top of systemic inflammatory response, might result in malnutrition even in non-hospitalised patients. However, no data is available on the impact of Covid-19 on nutritional status,” the study noted.

Treating doctors told indianexpress.com that a rise in conditions like type 2 diabetes, hyperthyroid conditions, postural orthostatic tachycardia syndrome (POTS), secondary pneumonia post-Covid, and Lond Hauler Covid symptom are also “leading to weight loss”.

When comparing patients with or without weight loss, the Milan study noted that those who lost weight had greater systemic inflammation (baseline CRP and, in hospitalised patients, peak CRP values), worse renal function (proportion of patients with an eGFR < 60 mL/min/1.73 m2), and longer disease duration. “Acute systemic inflammation deeply affects several metabolic and hypothalamic pathways contributing to anorexia and decreased food intake as well as elevation of resting energy expenditure and increased muscle catabolism. Acute inflammatory events can trigger persistent neuroinflammatory responses in vulnerable individuals, which may perpetuate inflammation and wasting even after the acute phase,” it reads.

Agreed Dr Navneet Sood, pulmonary consultant, Dharamshila Narayana Superspeciality Hospital but, however, said that weight loss may not be directly due to the infection but a “prolonged state of inflammation”. “This is not exactly due to infections only, but in many cases prolonged state of inflammation, of which infection is one part causing catabolic state in the body which may result in weight loss. Patients need to be more aware about their health even after being infection-free. Post-covid complications is a much bigger concern. Regular health check-up is the key,” said Dr Sood.

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