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Extremely obese people with Covid-19 are 17 times more likely to require admission to intensive care in Ireland than cases without an underlying condition, a new analysis shows.
While 1.4 per cent of patients who have contracted the virus in Ireland were categorized as extremely obese (a body mass index – BMI – greater than or equal to 40), almost half of them required hospitalization, according to the analysis. of official figures of scientists. at UCD.
Those who were extremely obese were 3.5 times more likely to require hospitalization. Only people with cancer, heart and kidney disease had a higher risk of having to go to the hospital.
Among those with a high BMI, the risk of serious outcomes from a Covid infection is not limited to the extremely obese. A BMI greater than 25 (overweight) is “bad news, more severe and fatal” for those affected, according to Professor Francis Finucane, a consultant endocrinologist at Galway University Hospital.
International evidence points to a linear relationship between BMI and risk of severe illness from Covid-19, says Professor Finucane.
In response to growing evidence of the link between obesity and severe Covid-19 disease, the Health Service Executive will expand its monitoring of this underlying condition.
Triage and treatment
Currently, surveillance for the disease is focused on people with a BMI of 40 or more. The categorization, traditionally used in influenza surveillance, was applied this year to Covid-19 monitoring.
The HSE told The Irish Times that it now planned to collect data on the weight of all ICU patients with the virus, categorized into those with a BMI of less than 30, those with a BMI of 30-40 and those above. .
Mark Roe, a UCD postdoctoral researcher specializing in injury risk management, performed the risk analysis of the underlying conditions using figures from the Center for Health Protection Surveillance. He said the information could help inform doctors’ decisions regarding triage and treatment of patients.
“It is a small but important piece of the puzzle, and since Covid-19 is going to be around for some time, it shows the need for interventions to reduce people’s risk, even the simplest and most inexpensive ones, such as exercising and eating healthy. healthy way. “
Professor Finucane said the link between the severity of Covid-19 and obesity “transcends the scales.”
Metabolic vs mechanical
“It’s really about metabolic problems rather than mechanical ones. While obesity is associated with a poor diet, this in itself does not cause the serious Covid problem.
“Rather, this is due to abnormal blood clotting, inflammation, and damage to the blood vessels in the lungs. This makes Covid more of a circulatory problem than a ventilatory one for patients and their caregivers. It has implications for how we might approach the problem. “
Obese cases tend to have other underlying conditions that put them at higher risk for serious infection, including diabetes. Non-white ethnicity is also associated with more serious outcomes.
“Instead of seeing it as an excess fat problem, we should see it in terms of excess calories. It’s not about how bulky someone is, it’s about their metabolism. “
Dr. Roe’s analysis shows that cases with chronic neurological disease have the highest risk of Covid-related death from any underlying condition, more than eight times higher than cases with no underlying condition.
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