Introduction

Does a high weight increase the severity of your viral infection? Recent research studies have found that obesity increases your risk of getting infections and sometimes increases the severity of viral coughs and colds. This is because people with obesity have reduced immunity, making the symptoms of the condition severe. As the body’s capacity to fight the virus (for example adenovirus that causes respiratory symptoms) is reduced, an obese person may be susceptible to a more severe and prolonged course of illness. Why does this happen and is there a way to improve the healing process? Please read on to find out more.¹

What is Adenovirus?

Adenovirus is one of the causes of a respiratory flu-like infection. This virus causes a more complex infection and can occur anytime during the year. It is highly contagious and spreads through air droplets from an infected person, direct contact with them, or contact with surfaces contaminated by them. Typically the person is contagious for the first 3 to 4 days of having the symptoms.²

Some typical symptoms of an adenovirus infection include the following.

• Fever
• Cough
• Sore throat
• Runny nose
• Feeling generally unwell

Adenovirus infection can also present with symptoms of the gut such as diarrhoea and stomach ache. It can also cause an eye infection called conjunctivitis.

Some severe complications of this condition include the following:

• Pneumonia
• Bronchitis
• Severe respiratory dysfunction²

Understanding obesity

Obesity is a medical condition characterised by increased accumulation of body fat. It is usually diagnosed by a healthcare professional when the person has a body mass index (BMI) greater than 30. Obesity increases an individual’s susceptibility to various conditions including type 2 diabetes, heart diseases, immune conditions and even certain cancers.³

So why does obesity lead to increased severity of a disease? This is because of its relation to our immunity. Higher levels of stored body fat, also called adipose tissue, result in persistent low levels of inflammation in the body which in turn causes a deficient immune response. This reduces the body’s capacity to fight off disease-causing viruses. This also results in prolonged duration of viral illnesses such as adenovirus due to reduced immunity.⁴

And what does this mean for an obese person who has an adenoviral infection? People with obesity are likely to undergo some complications of adenovirus. These could include bronchitis or pneumonia. This could also mean that the person may have to be admitted. There is also an increased risk of complications during admissions (such as longer periods in the hospital or admission to the intensive care unit).⁵ Let us understand why this happens as we read further.

Does obesity increase the severity of an adenovirus infection?

When an obese person gets the adenovirus infection, they are more susceptible to experiencing a more severe form of the illness. Some of the specific ways that obesity affects the body making it more likely to suffer through severe symptoms are discussed below.

• Increased risk of complicated symptoms of disease: Obese individuals are more likely to develop prolonged cough and flu-like symptoms, breathing difficulties and fatigue. There is also an increased risk of the infection reaching the lungs (pneumonia), and distress to the lungs and airways leading to reduced lung function and problems with breathing (Acute respiratory distress syndrome)⁵
• Long term complications: Due to the lowered immune response in obesity, the chances of developing long term complications in the lungs and heart are higher even after the infection has been treated⁶
• Prolonged illness: Adenoviral infections usually last for a week. But this may be significantly prolonged in obese individuals. The recovery time is longer due to reduced capacity of the immune system to fight the infection⁷
• Hospitalisation: Due to the possibility of complications especially in the lungs, obese individuals are more likely to be hospitalised when compared to non-obese patients⁸

These complications reveal the importance of keeping a watch on your symptoms and detecting the warning signs. Some warning signs indicating a visit to your GP include:

• Severe painful cough
• Prolonged cough
• Persistent fever
• Cough with sputum (especially white, yellow or green sputum)
• Breathlessness while doing your daily activities
• Breathlessness while resting
• Pain in the chest or upper back
• General feeling of tiredness or aches and pains lasting for more than a week⁹

Management of adenovirus in obese individuals

While the complications of adenovirus in obese individuals are severe, prompt management of the condition can ensure that the illness does not progress to more severe symptoms. Some treatment strategies include:

• Medications: Managing the pain and fever involves using over the counter medications such as paracetamol under the guidance of your pharmacist or GP. Cough syrups, lozenges or simply drinking lemon and honey water can help soothe your throat. Use sugar free cough syrups and lozenges if you have type 2 diabetes
• Fluid intake: Drink plenty of fluids such as water, mild tea, clear soups and fresh fruit juices (avoid processed and sugary drinks). Maintaining your fluid intake helps with the symptoms of viral infections and promotes a relatively speedy recovery
• Monitoring for complications: Due to an increased risk of complications, especially pneumonia and respiratory distress, it is important to note the warning signs and seek urgent medical attention when suspected 
• Follow up and monitoring: This is important especially during the recovery period to monitor any further complications. Regular health check ups with the GP are necessary to promptly deal with any complications¹⁰

Healthcare professionals can assess the severity of the condition and ensure that the right treatment is given before the illness progresses to a more severe course. So it is important to seek medical attention promptly, especially in obese individuals.

Preventive strategies

Some preventive strategies can be implemented to reduce the risk of getting the infection. These include:

• Hand hygiene: Practising good hand hygiene is crucial. Wash your hands thoroughly with soap and water especially after sneezing, coughing or coming in contact with contaminated surfaces (after using public transport, using public spaces, coming in contact with an infected person). Alcohol based hand sanitisers can be used when it is not possible to wash your hands with soap and water
• Maintaining hygiene in your surroundings: ensuring that surfaces that have come in contact with infected individuals, such as things you bought from the supermarket, coats, bags and even your phone, are sanitised before usage
• Avoiding close contact with infected individuals: Avoid closely interacting with people who experience respiratory symptoms. Follow social distancing measures, such as keeping a one-metre distance and wearing masks. Adenovirus is highly contagious. Avoid crowded places when possible to reduce risk of exposure to infectious diseases¹¹
• Healthy lifestyle: Developing healthy habits can help improve your body’s immune system, thereby improving your ability to fight off infections, such as the adenovirus infection. Eating nutritious foods and avoiding processed foods, creating a balanced exercise regimen, getting adequate sleep, avoiding smoking and alcohol consumption and limiting caffeine consumption (especially in the evenings) are some of the ways you can incorporate healthy habits in your lifestyle^12,15

Long-term effects of adenovirus infection in obese individuals

Adenovirus infections can cause long-term effects on the body, even after the infection is resolved. The most common effect is seen in the lungs, however, there can be complications involving the:

• heart and blood vessels
• metabolism 
• immunity 
• some psychological impact as well 

Let us discuss some of these below.

• Pulmonary complications: Adenovirus can cause damage to the lungs even if the adenovirus pneumonia was treated completely. This can make individuals susceptible to respiratory illness in the long term such as bronchiectasis (when the airways in the lungs are widened) and chronic obstructive pulmonary disease (which causes the airways to narrow and make it difficult to absorb oxygen from the air we breathe in). In children, adenovirus can cause an increased risk of recurrent wheezing, bronchitis and asthma exacerbations
• Cardiovascular complications: Adenovirus infections can trigger certain changes in the blood vessels and heart muscles, which can contribute to the development of heart disease. It can increase the chances of high blood pressure, myocardial infarction and stroke, especially in obese individuals¹³
• Metabolic effects: Obese individuals with a history of adenovirus infection can be at a risk of developing high blood sugar (diabetes type 2), high blood pressure, and abnormal fat levels in blood¹⁴
• Immune dysfunction: Adenovirus infection can have further effects in obese individuals, who already have a compromised immune system. This can increase the susceptibility to chronic illnesses, frequent infections and autoimmune disorders
• Psychological impact: Chronic illness and long-term health complications can increase the risk of developing stress, anxiety and depression, especially in obese individuals. This impacts daily functioning and perception of health. It is vital to discuss getting psychological support and counselling with your GP¹⁵

FAQs

What are the symptoms of adenovirus infection in obese individuals?

The symptoms of adenovirus infection in obese individuals can vary but commonly include respiratory symptoms such as cough, sore throat, and shortness of breath, as well as gastrointestinal symptoms like diarrhoea and vomiting. Obese individuals may also experience widespread symptoms such as fever, fatigue, and body aches.

Is adenovirus infection more severe in obese individuals?

Yes, adenovirus infection can be more severe in obese individuals, leading to complications such as pneumonia and respiratory distress. Obese individuals are at higher risk of severe illness and hospitalisation due to adenovirus infection compared to non-obese individuals. 

Can adenovirus infection lead to long-term health problems in obese individuals? 

Adenovirus infection in obese individuals can have long-term health consequences, including respiratory complications such as asthma exacerbations and chronic obstructive pulmonary disease (COPD), cardiovascular complications such as hypertension and coronary artery disease, and metabolic consequences such as type 2 diabetes mellitus and dyslipidemia. 

How can adenovirus infection be prevented in obese individuals?

Preventive strategies for adenovirus infection in obese individuals include good hygiene practices, and healthy lifestyle choices such as regular exercise, balanced nutrition, and smoking cessation. Obese individuals should also receive the annual flu vaccine to reduce the risk of respiratory infections.

What is the treatment for adenovirus infection in obese individuals?

The treatment of adenovirus infection in obese individuals primarily involves supportive care, including rest, hydration, and symptom management. In severe cases, hospitalisation may be necessary for close monitoring and intravenous fluids. There are currently no specific antiviral medications available for adenovirus infection. 

Can adenovirus infection in obese individuals increase the risk of other infections? 

Yes, adenovirus infection in obese individuals can weaken the immune system and increase the risk of other infections, including bacterial superinfection and opportunistic infections. Obese individuals should be vigilant about practising good hygiene and seeking prompt medical attention if they develop new symptoms.

Is there a link between adenovirus infection and obesity-related comorbidities?

Yes, adenovirus infection can exacerbate obesity-related comorbidities such as type 2 diabetes mellitus, hypertension, and cardiovascular disease. Chronic inflammation associated with adenovirus infection may worsen metabolic dysfunction and contribute to the progression of obesity-related complications.

Summary

Adenovirus infections can affect both children and adults, presenting with symptoms such as runny nose, cough, diarrhoea, stomach ache, fever, fatigue, and general weakness. While most cases resolve within a week, infections can be more severe in obese individuals, requiring prompt treatment. Management includes fever and pain relief with paracetamol, cough syrups, fluid intake, healthy nutrition, and rest, with hospitalization for severe cases.

Obese individuals are at greater risk of complications like pneumonia, respiratory distress, lung diseases, heart problems, and metabolic disorders, as well as mental health issues like stress and depression. Preventative strategies include frequent hand washing, sanitizing surfaces, avoiding crowded places, wearing masks, and maintaining social distancing.