The findings, published Friday in the Journal of the American College of Cardiology, provide a deeper analysis of Novo’s largest Wegovy trial, called Select. When the pandemic hit, the research was already enrolling more than 17,600 people with obesity, now known to be a risk factor for severe Covid, and heart disease. 

While insurers and lawmakers assail prices for weight-loss treatments, Novo and Eli Lilly & Co., the maker of rival drug Zepbound, are striving to show their costly drugs offer broad benefits that merit coverage from insurers and government health plans. Last year, results from the Select study showed that patients on Wegovy were 20% less likely to suffer a heart attack or stroke than those on placebo, later opening the door to broader insurance coverage. How the drug might have helped Covid patients still isn’t completely clear. 

The research “highlights the relationship between obesity and Covid disease severity,” said Barry Popkin, a nutrition professor at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health who wasn’t involved in the study. “We do not know if this relates to the reduced lung capacity of individuals with obesity or other pathways such as reduced inflammation.”

When Covid emerged, no one suspected that Wegovy, made with the active ingredient semaglutide, would reduce deaths from the virus wreaking havoc across the world, according to Donna Ryan, a professor emeritus at Pennington Biomedical Research Center in Baton Rouge, Louisiana, who helped write the study. The latest results underscore the drug’s far-reaching effects on metabolism and inflammation, important factors in the body’s response to infection and other types of disease. 

“It’s not just weight loss, it’s not just diabetes,” said Ryan, who was on Novo’s steering committee for the Select trial and has consulted for other pharmaceutical companies. The effect of the drug is “much broader.”

Lilly has begun exploring the anti-inflammatory effects of Zepbound, planning studies in conditions such as psoriasis. The market for drugs that control the harms of inflammation — about $100 billion this year — is among the world’s biggest. 

Obesity and Covid

The link between body weight and Covid became clear early in the pandemic. People with obesity who were diagnosed with Covid were more than twice as likely to be hospitalized, 74% more likely to need an intensive care unit and 48% more likely to die than non-obese people, according to a 2020 study that Popkin led.

In the first eight months of the pandemic, about 30% of Covid hospitalizations were among patients who also had obesity, according to data from the US Centers for Disease Control and Prevention. 

About 2.6% of Select study participants who took Wegovy had severe Covid-related events or died, compared with 3.1% of those who got a placebo. The data didn’t show that Wegovy prevents Covid infections. About a quarter of trial participants reported Covid infections, with similar rates among those who were on Wegovy and those on placebo.  

Reductions in Covid deaths among those on Wegovy also contributed to lower overall death rates in this group compared to patients on placebo, researchers said. Novo scientists are still mining the data for insights about the drug’s effects.

The results “underscore the transformative potential of targeting obesity” to protect against a broad spectrum of health threats, Harlan Krumholz, a professor at the Yale School of Medicine, said in a statement.