Obesity and Nutritional Vulnerability in long COVID: A Neuroinflammatory and Cognitive Perspective

To examine the interplay between obesity, nutritional vulnerability, and long COVID, with a particular focus on neuroinflammatory and cognitive outcomes. This review synthesizes emerging evidence on shared pathophysiological pathways and evaluates the therapeutic potential of dietary and weight management strategies.

Cognitive symptoms such as brain fog and memory deficits are among the most persistent and disabling features of long COVID. Obesity is associated with more severe manifestations through pathways involving chronic systemic inflammation, compromised blood-brain barrier integrity, and neuroimmune dysregulation. Concurrently, malnutrition and poor diet quality including low intake of antioxidants, omega-3 fatty acids, and micronutrients may impair neuroplasticity and delay recovery. Interventions such as Mediterranean and ketogenic dietary patterns, as well as structured weight loss programs, show promise in reducing inflammation and improving cognitive outcomes. Obesity and suboptimal nutritional status amplify the neurocognitive burden of long COVID through shared pathophysiological mechanisms. Integrated care models that incorporate metabolic screening, nutritional assessment, and individualized dietary interventions may improve recovery trajectories. Public health strategies that address food quality, obesity prevention, and equitable access to nutrition care are essential for long-term resilience in the post-COVID era.