Overweight, Obesity Associated With Neurologic and Neuropsychiatric Symptoms in Post-COVID-19 Condition

Individuals with overweight or obesity are more likely to experience long-term neurological and neuropsychiatric symptoms in post-COVID-19 condition (PCC), also known as long COVID, according to new research published by investigators from Edith Cowan University (ECH) Centre of Precision Health in PLoS One.^1,2

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PCC can occur following infection with SARS-CoV-2 infection, the virus that causes COVID-19, and can afflict patients across a variety of ages and demographics. It is a serious condition that results in long-term, chronic disability, with symptoms that can last for months or years following COVID-19 infection. According to the CDC, groups who are at risk of developing PCC include those with underlying health conditions, such as obesity and overweight.³

Investigators from ECH sought to conduct a systematic review and meta-analysis to assess whether excess weight was associated with the development of neurological and neuropsychiatric symptoms in patients with PCC. They conducted a search of 8 databases for studies published up until July 2023, and studies were included if they assessed PCC symptoms in relation to patient nutrition status. In particular, the development of neurological and neuropsychiatric symptoms more than 12 weeks post-infection was a key basis for study inclusion.¹

A total of 18 studies including 139,091 adults were featured in the review. The included studies enrolled 79,050 individuals with excess weight versus 57,926 normal-weight individuals, along with 30,694 individuals with obesity compared with 107,612 non-obese enrollees.¹

According to the review, presence of excess weight in PCC was significantly associated with persistent depression (risk ratio [RR]: 1.21; 95% CI, 1.03—1.42), headache (odds ratio [OR]: 1.23; 95% CI, 1.10—1.37), memory issues (RR: 1.43; 95% CI, 1.24—1.65), sleep disturbance (RR: 1.31; 95% CI, 1.16—1.48), and vertigo (RR: 1.21; 95% CI, 1.04—1.41). Furthermore, obesity was meaningfully associated with persistent headache (OR: 1.45; 95% CI, 1.37—1.53), numbness (RR: 1.61; 95% CI, 1.46—1.78), smell disorder (OR: 1.16; 95% CI, 1.11—1.22), taste disorder (OR: 1.22; 95% CI, 1.08—1.38), and vertigo (RR: 1.44; 95% CI, 1.35—1.53), according to the study authors.¹

“What stood out was the consistency of findings across a wide range of neurological and neuropsychiatric symptoms—including memory problems, depression, sleep disturbances, and sensory impairments,” Débora Barbosa Ronca, visiting PhD scholar at ECU, said in the news release. “While we did not perform subgroup analyses by ethnicity, the inclusion of studies from 23 different countries suggests the global relevance of our findings.”²

Ronca explained that, although the mechanisms behind this association between excess weight and PCC are unclear, they could be linked to an exaggerated inflammatory response predisposed by excess fatty tissue. Accordingly, fatty tissue aids the SARS-CoV-2 virus when it enters the body, and could store the virus for prolonged periods, leading to PCC. The reality that many patients with PCC are affected by symptoms for 12 months or longer necessitates research into disease characteristics, which can aid in treatment development.^1,2

“These symptoms of long COVID can significantly impact quality of life and may linger for months,” Ronca explained. “As we face overlapping public health challenges in the post-pandemic era, such as long COVID, mental health issues, and rising rates of obesity, it’s essential to develop personalized and multidisciplinary care strategies to better support affected individuals.”¹

Pharmacists should note that patients with obesity or overweight who are infected with SARS-CoV-2 may be at higher risk for developing PCC and monitor them accordingly following their infection.²

REFERENCES

1. Ronca DB, Mesquita LO, Oliveira D, et al. Excess weight is associated with neurological and neuropsychiatric symptoms in post-COVID-19 condition: A systematic review and meta-analysis. PLoS One. 2025;20(5):e0314892. doi:10.1371/journal.pone.0314892

2. Edith Cowan University. New study shows obesity linked to long COVID. EurekAlert! News Release. Released May 7, 2025. Accessed June 12, 2025. https://www.eurekalert.org/news-releases/1083101

3. CDC—COVID-19. Long COVID basics. Last Updated February 3, 2025. Accessed June 12, 2025. https://www.cdc.gov/covid/long-term-effects/index.html