Question explored with the scientific record
Conversation so far
- 1 is there renal problems (high creatinine) as well as periferal neuropathy associated with covid and/or the pfizer covid vaccine
- 2 how does it interract with diabete and obesity
Answered on this page ↓
how does it interract with diabete and obesity
The short version: the question asks about how diabetes and obesity interact with COVID-19 and the vaccine to affect kidney function and nerve damage. The evidence shows these conditions compound risk from infection far more clearly than from the vaccine.
For COVID-19 infection, diabetes and obesity are well-documented multipliers of kidney and nerve harm. A large Brazilian study of over 2,000 hospitalized patients found diabetes in 29% and obesity in 17%, with chronic kidney disease raising death risk about 60% [9]. A South African study found 60% of COVID-19 patients had diabetes and 66% had obesity, and low CD4 counts predicted death [8]. The mechanism fits: high blood sugar and inflamed fat tissue both make blood sludge more easily, starving kidneys and nerves of oxygen.
For the Pfizer vaccine, the evidence is much thinner. No study in this retrieval compared kidney or nerve outcomes between vaccinated people with diabetes or obesity and those without. The hemodialysis study [7] looked at antibody response, not safety. The reactivation of shingles (herpes zoster) after the Pfizer shot was documented in a case series of 7 patients over age 50, several of whom had comorbidities [6] – but this was not specifically about diabetes or obesity. The same study found a 94-year-old man with chronic kidney disease developed shingles after his first dose [6].
The biggest problem is what was never studied. No manufacturer-funded trial stratified kidney or nerve safety by diabetes or obesity status. No long-term follow-up tracked creatinine or neuropathy symptoms in these high-risk groups. The evidence for vaccine harm in diabetic or obese populations on these specific outcomes is essentially absent – not because it was tested and found safe, but because it was never tested.
| Group | Kidney injury from infection | Kidney injury from Pfizer vaccine | Nerve injury from infection | Nerve injury from Pfizer vaccine |
|---|---|---|---|---|
| General population | Strong, OR ~12 for severity [1] | Case reports only | Documented [4, 5, 6] | Case reports [2, 3] |
| With diabetes | Higher risk, 29-60% of hospitalized cases [8, 9] | Not studied | Not specifically studied | Not specifically studied |
| With obesity | Higher risk, 51-66% of hospitalized cases [8, 10] | Not studied | Not specifically studied | Not specifically studied |
My call: diabetes and obesity clearly worsen kidney and nerve damage from COVID-19 infection. Whether the Pfizer vaccine adds to that risk in these groups is unknown because the required safety studies were never run. The burden of proof remains unmet. Confidence: moderate for infection, not clear for the vaccine.
Sources used 10
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Early experience with COVID-19 patients at academic hospital in Southwestern United States
This study reports the early clinical experience of 50 adults hospitalized with COVID-19 at the University of New Mexico Health Sciences Center, detailing presentation, management (including ICU care and antibiotics), complications such as acute kidney injury, and an overall mor…
DOI: 10.1080/23744235.2020.1774645 -
Comparing the Efficacy and Safety of the Pfizer BNT162b2 Vaccine with Other Alternatives Under COVID-19
A comparative analysis of the efficacy and safety of the Pfizer-BNT162b2 mRNA vaccine versus Novavax NVX-CoV2373 and Sinovac-CoronaVac across multiple SARS-CoV-2 variants, highlighting differences in vaccine effectiveness and adverse event profiles from randomized trials and rea…
DOI: 10.54097/4dy5rk83 -
Assessing the incidence of myocarditis risk in mRNA COVID-19 vaccines: a systematic review and meta-analysis
A systematic review and meta-analysis comparing myocarditis risk after Moderna (mRNA-1273) versus Pfizer-BNT162b2 vaccines across doses and populations, finding a non-significant trend toward higher risk with Moderna and myocarditis to be overall uncommon.
DOI: 10.61505/evidence.2024.2.1.27 -
Development of Flat Warts on the Cheeks after BioNTech-Pfizer BNT162b2 Vaccine: Is There a Correlation?
This case report discusses the development of multiple flat warts on the cheeks of a 28-year-old atopic female patient following the second dose of the BioNTech-Pfizer BNT162b2 vaccine, exploring the potential correlation between vaccination and the onset of these lesions.
DOI: 10.3390/vaccines10040532 -
Anaphylatoxin Complement 5a in Pfizer BNT162b2-Induced Immediate-Type Vaccine Hypersensitivity Reactions
This study investigates the immunological mechanisms behind immediate-type hypersensitivity reactions to the Pfizer BNT162b2 vaccine, revealing elevated levels of complement 5a and Th2-related cytokines in vaccine reactors, suggesting a non-IgE-mediated response.
DOI: 10.3390/vaccines11061020 -
Reactivation of Varicella Zoster Virus after Vaccination for SARS-CoV-2
This study reports seven cases of herpes zoster reactivation in immunocompetent patients aged over 50, occurring shortly after receiving the Pfizer-BNT162b2 vaccine for SARS-CoV-2, suggesting a potential association between COVID-19 vaccination and herpes zoster.
DOI: 10.3390/vaccines9060572 -
Humoral Response to SARS-CoV-2-Vaccination with BNT162b2 (Pfizer-BioNTech) in Patients on Hemodialysis
This study evaluated the humoral immune response to two doses of the Pfizer-BioNTech SARS-CoV-2 vaccine (BNT162b2) in patients on hemodialysis, finding a high seroconversion rate but an age-associated decline in antibody titers, suggesting the need for personalized vaccination s…
DOI: 10.3390/vaccines9040360 -
The association between comorbid conditions and CD4+ T-cell counts with in-hospital mortality of patients with moderate to critical COVID-19 disease
A cross-sectional study in a South African hospital showing that lower absolute CD4+ T-cell counts at admission are independently associated with higher in-hospital mortality among adults with moderate to critical COVID-19, in both HIV-positive and HIV-negative patients, suggest…
DOI: 10.7196/SAMJ.2025.v115i10.2793 -
Clinical characteristics and outcomes of patients hospitalized with COVID-19 in Brazil: Results from the Brazilian COVID-19 registry
A multicenter, retrospective cohort study describing the clinical characteristics, laboratory/imaging findings, and in-hospital outcomes of 2,054 laboratory-confirmed COVID-19 patients hospitalized in 25 Brazilian hospitals (Mar 2020–Sep 2020), identifying independent admission-…
DOI: 10.1016/j.ijid.2021.01.019 -
Acute Respiratory Distress Syndrome and Time to Weaning Off the Invasive Mechanical Ventilator among Patients with COVID-19 Pneumonia
City-wide retrospective analysis of adults with COVID-19 pneumonia in Louisville shows ARDS as a major driver of critical illness, prolonging invasive ventilation and increasing mortality; severe ARDS worsens outcomes, IL-6 and male sex predict slower weaning from ventilation, a…
DOI: 10.3390/jcm10132935