Abstract
We present a hypothesis for increased sugar consumption and a lack of physical exercise as possible determinants of COVID-19 disease severity by impaired glucose metabolism, concurring into a syndemic. National data demonstrate that increased sugar consumption, a high daily caloric intake, and low levels of daily physical activity are independently associated with COVID-19 mortality. Further, genetic factors such as variations in the androgen receptor may compound the effects of an unhealthy lifestyle and increase the risk of severe COVID-19 symptoms in some patients. A diet high in sugar in combination with a low level of physical activity may increase blood glucose levels and impair glucose metabolism. Recent data show that patients admitted to the hospital with high levels of fasting blood glucose are at an increased risk for severe COVID-19 symptoms. Moreover, elevated glucose levels resulted in increased SARS-CoV-2 viral loads in vitro. We believe that healthier habits of diet and exercise, by improving glucose homeostasis could modulate the individual risk of severe COVID-19 symptoms.