A School of Nursing professor is collaborating with the Department of Veteran Affairs for a five-year study that launched in April 2024 to examine the relationship between obesity and long COVID, with an emphasis on its effects on veterans.
Kathleen Griffith, a professor of nursing at GW and the associate dean of research at the School of Nursing, and Alice Ryan, a professor of medicine at the University of Maryland School of Medicine, are co-leading the $1.9 million research project funded by the Department of Veteran Affairs and will study how obesity impacts the severity of long COVID symptoms like coughing and muscle pain. Griffith said she hopes the study will facilitate the long-term rehabilitation of veterans suffering from long COVID through physical therapy and weight loss interventions and provide guidance to physicians on treating the intersection of the two conditions in the future.
“The research team is focused on long-term rehabilitation of veterans with chronic health conditions in the Veteran population,” Griffith said in an email. “We hope our work will provide insight into the value of exercise and weight loss as an intervention to reduce PCCs.”
Long COVID, otherwise known as Post-COVID Conditions, can cause multiple health issues in patients. Griffith said symptoms of long COVID can include fatigue, cough, mental fogginess and muscle or joint pain, among others.
Ten percent of veterans who contracted COVID later developed long COVID symptoms, according to the Department of Veterans Affairs. The Centers for Disease Control and Prevention found that among the general population who had COVID, only about 6.9 percent of adults had long COVID.
Griffith said veterans are twice as likely to suffer from PCCs as the general population, and she hopes that the study will serve as a “starting point” for research and treatments for long COVID. She said it is unclear among researchers why veterans are more at risk of experiencing long COVID.
“The risk factors of PCCs in veterans including advanced age, chronic health conditions, more severe acute COVID-19 at first presentation, and lack of vaccination, are not different from risk factors in the general population,” Griffith said in an email.
Griffith said the five-year study will examine the effectiveness of weight loss interventions in increasing quality of life and reducing tissue inflammation and cellular aging, which can further contribute to the symptoms of long COVID in veterans.
The School of Nursing’s website states that the study will use a randomized controlled trial to determine the effects of exercise and weight loss in improving the physical functioning and quality of life of veterans suffering from long COVID symptoms.
Veterans experience obesity at higher rates than the general population — with only 27.8 percent being at a healthy weight compared to 42.6 percent of the population, according to the National Institute of Health, which some studies have suggested could be due to the stress of transitioning back to normal life after serving.
“It will evaluate whether a weight loss intervention, including dietary modification and exercise, in obese veterans with and without PCC will reduce whole body and adipose tissue inflammation and deterioration and promote PCC recovery,” Griffith said in an email. “So this research has both functional and mechanistic aims.”
Physical therapists and professors of respiratory research said responses to treatments like exercise and dietary restrictions can vary in efficacy across demographic groups and studies should prioritize finding treatments that work for an array of patients, as patients likely to have pre-existing health conditions like veterans may respond to treatments differently.
Louise Wain, a professor of respiratory research at the University of Leicester, said groups of people with preexisting conditions like obesity are more susceptible to COVID as it is a preexisting health condition that can impair the immune system. She said veterans may be more likely to experience severe long COVID symptoms because of the high rates of obesity in the population.
Wain said because individuals with long COVID may experience diverse symptoms on a large spectrum and may respond differently to different types of treatments like physical therapy and dietary changes, there is a need for better understanding among researchers and physicians.
“There was this evidence from some trials that sort of physical rehabilitation can help for some people, but it’s not suitable for everybody,” Wain said. “So there are groups of people who experience a negative response to physical activity as a consequence of their long COVID.”
Wain said the effects of long COVID can preclude people from returning to their normal daily lives in the years that follow, which is why research into rehabilitation is needed.
“At the worst end of the spectrum, there’s people who just haven’t been able to return to their jobs,” Wain said. “They struggle to function in their daily life. They struggle to look after themselves, they struggle to look after their family members and obviously, that’s an important impact on quality of life.”
Todd Davenport, a professor of physical therapy at the University of the Pacific, said studies need to focus more on finding a cure for long COVID symptoms rather than evaluating risk factors in demographics.
“The fact that we’re five years into this pandemic and there are no approved tests or cures for long COVID is really unconscionable,” Davenport said. “The research to date in long COVID has really focused on demographic research, understanding risk factors, and while all of that information is relevant and important, it doesn’t get us much closer to a cure.”
Davenport said he hopes to see the emergence of treatments for and research of the mechanisms that cause long COVID, and researchers should work with different groups to see what works rather than focusing on a single solution.
“Hopefully we’ll have an array, a range of treatments that will address the mechanistic underpinning of people’s long COVID,” Davenport said. “Not just thinking of, there’s a single pill for long COVID, and that’s not going to be where we’re at. But I think there’s a lot more research that we need to do at the basic, mechanistic level.”
