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Another great reason to keep getting out on the bike has emerged with research now confirming a worrying relationship between obesity and the impacts of COVID-19.

Not only are the obese more at risk of catching COVID, it hits them far harder.

Those with obesity are more at risk of being positive (46%), at a greatly increased risk for hospitalization (113%), more likely to be admitted to the intensive care unit (74%), and had a higher risk of death (48%) from the virus.

Obesity was defined as a body mass index (BMI) above 30.

The research group from the University of North Carolina at Chapel Hill undertook a systematic review of 75 studies into COVID to assess the relationship of individuals to the disease over the full spectrum from risk to mortality.

But the findings had even more worrying implications: the obese developed more severe complications, available treatments were less effective, and there is now major concern that vaccines will be less effective for the obese.

The paper, clear and well written, is available here.

Obesity is already associated with numerous underlying risk factors for COVID-19, including hypertension, heart disease type 2 diabetes, and chronic kidney and liver disease.

Metabolic changes caused by obesity — such as insulin resistance and inflammation — make it difficult for individuals with obesity to fight some infections, a trend that can be seen in other infectious diseases, such as influenza and hepatitis.

During times of infection, uncontrolled serum glucose, which is common in individuals with hyperglycemia, can impair immune cell function.

"All of these factors can influence immune cell metabolism, which determines how bodies respond to pathogens, like the SARS-CoV-2 coronavirus," says co-author Melinda Beck, professor of nutrition at Gillings School of Global Public Health.

"Individuals with obesity are also more likely to experience physical ailments that make fighting this disease harder, such as sleep apnea, which increases pulmonary hypertension, or a body mass index that increases difficulties in a hospital setting with intubation.”

Working from home requirements, and other movement restrictions, have resulted in people sitting more and engaging in less physical activity. And sitting at home, people are consuming more take away junk food. The pounds are packing on.

The coronavirus is cleverly exploiting the very behaviours that we have adopted as we evade it.

As a society we must ensure that these bad habits don’t persist.

With plenty of bike riding and physical activity we can stay strong and lean, reduce our chances of getting the disease, improve our chances of recovering from it, and help ensure that vaccines, when they come, do their best work.