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Scientists fear that fat will provoke a ‘problematic’ immune response to COVID-19.
Scientists advising government ministers are exploring possible underlying mechanisms that could increase the risk of death for obese patients.
According to data from intensive care units, people with a healthy weight constitute a minority of critical patients with COVID-19. Almost three quarters carry extra weight.
And this week’s NHS hospital data revealed that obesity increases the risk of dying from coronavirus by nearly 40 percent.
While the reasons remain unclear, scientists have warned of a possible dysfunctional immune system that makes it difficult to fight the virus.
Fat cells, of which there are more in the tissues of obese people, can harbor vital immune cells, reducing their availability in the rest of the body.
Or it can turn the other way: The immune response can go into overdrive, known as a cytokine storm, believed to play a role in COVID-19’s death.
There has been no data to suggest that obese people are more likely to get the killer virus in the first place.
Being fat triggers a ‘problematic’ immune response to COVID-19, scientists fear, as the government’s SAGE committee investigates why obesity increases the risk of death.
According to the ICNARC report, people at a healthy weight constitute a minority of critical patients with COVID-19. Almost three quarters have extra weight (BMI 25 to 40+)
The Sunday Times reports that the SAGE committee will investigate the relationship between obesity and severe COVID-19 disease.
As the death toll from the virus in the UK reaches more than 28,000, data collection from NHS hospitals has revealed those most at risk.
It includes people with obesity, those with underlying health conditions, and people with a BAME history. Men also represent more than 70 percent of patients.
There is a higher proportion of people with obesity in critical care than in the general population, according to the National Center for Intensive Care Audit and Research, which collects data from NHS hospitals.
The figures, released on Friday, are based on a sample of 7,542 critically ill patients confirmed with Covid-19.
According to the ICNARC report, people at a healthy weight constitute a minority of critical patients with COVID-19.
Almost three-quarters (73 percent) carry extra weight.
About 35 percent have a BMI between 25 and 30, which the NHS considers “overweight,” 31 percent are obese, and just over seven percent are severely obese.
For comparison, in the general population of England, 64.3% of adults are overweight (35.6%) or obese (28.7%), as shown by the 2019 government data.
There are more people with morbid obesity in critical care (7.32) than in the population (3.6 percent in England).
Dr. Dyan Sellayah, professor of organism and cellular metabolism at the University of Reading, said: ‘What we know from the data so far is that obesity is a clear risk factor for serious disease.
“Obese people tend to have dysfunctional immune systems: their adipose tissue, for example, becomes a reservoir of immune cells known as macrophages.”
‘Although these cells reside in our fat under normal circumstances, in obesity they are more frequent and more problematic (they begin to secrete inflammatory cytokines) and have a negative impact on immune and metabolic health.
“The immune response to the virus is likely to be therefore ineffective in obese people, which may explain why people with a BAME history who have a higher incidence of obesity are vulnerable to the virus.”
Studies have shown that obese people are more likely to suffer serious complications or die from infections, like the flu, because their immune systems are constantly getting stronger as they try to protect and repair the damage that inflammation causes to cells.
Using all of your energy to fend off inflammation means the body’s defense system has few resources left to fend off a new infection like COVID-19.
Obesity is a major risk factor for comorbidities, including heart disease, diabetes, and high blood pressure, all of which have been identified as common medical conditions among COVID-19 patients.
People with underlying health conditions are more vulnerable to serious illnesses from the virus.
Research published this week, considered the largest of its kind in Europe, revealed that more than half (53 percent) of COVID-19 patients in the UK had at least one comorbidity.
Nearly a third (29 percent) had heart disease, conditions that block blood vessels and make it difficult for blood and oxygen to pump throughout the body.
Almost a fifth (19 percent) were diabetic, the same number had lung disease, 15 percent had kidney disease, and 14 percent were asthmatic.
The same report revealed that once in the hospital, survival rates may be lower among obese people.
COVID-19’s analysis of 17,000 admissions found that death rates were 37 percent higher among obese patients, second only to dementia (39 percent) but higher than heart disease (31 percent).
The research was conducted by a team of Britain’s leading infectious disease scientists who are part of the global pandemic planning agency.
Researchers who analyzed nearly 17,000 COVID-19 admissions revealed that obesity increases the risk of dying from the coronavirus by almost 40 percent. More than half (53%) of hospitalized patients had at least one comorbidity (shown in the image). The most common were heart disease (29 percent), diabetes (19 percent), lung disease (19 percent), kidney disease (15 percent), and asthma (14 percent)
Reduced lung function and inflamed tissue under the skin and around internal organs may be linked to an increased risk, the team said.
They found that both factors can trigger an overreaction of the body’s immune response that is life-threatening and causes harm to patients.
Cytokines are chemical signaling molecules that guide a healthy immune response. They tell immune cells to attack viral molecules in the body.
But in some people, this response goes into overdrive, and immune cells also begin to attack healthy tissue, known as a cytokine storm.
Fredrik Karpe, a professor of metabolic medicine at the University of Oxford, said that if “you have a big belly,” this can be problematic when you lie down.
The weight of stomach fat pushes the diaphragm upward, reducing lung volume.
COVID-19 is a respiratory disease that, in severe cases, affects lung function. Therefore, restricted lung capacity would aggravate symptoms.
If lung function has already deteriorated, oxygen in the blood has a limited supply that can affect vital organs, such as the heart.
Dr. Sellayah also explained that people who are overweight have more cells that require oxygen to function, further reducing the amount available to organs.
He said: ‘As their infection progresses and the virus infects more and more cells, the demand for oxygen in the tissues is much higher for an obese individual than for a thin individual.
“Finally, the obese body is overwhelmed by the lack of oxygen that reaches the main organs.”
As the country is affected by the coronavirus crisis, being overweight and the associated health risks stand out like never before.
Last week, a British NHS doctor said today that Prime Minister Boris Johnson was badly affected by the coronavirus because he is “significantly” overweight.
Consulting cardiologist Dr. Aseem Malhotra said there is a tenfold increased risk of death from the disease, which has so far killed more than 20,000 Britons if the patients are obese.
He noted that other “slimmer” Cabinet members, such as Health Secretary Matt Hancock, recovered much faster and were not hospitalized.
Other senior government officials and advisers who have recovered from the virus include Chief Medical Officer Chris Whitty, Senior Adviser Dominic Cummings, and Health Minister Nadine Dorries.
Johnson, 55, has long struggled with his weight and in 2018 revealed that he weighed in at nearly 16-and-a-half stone, putting him at 5-foot-9 in the high-risk category.
Dr. Malhotra said: “It was obviously very troubling for the entire nation to see our Prime Minister admitted to the hospital with COVID-19.
‘Now it’s an observation, but it fits the evidence, Boris is unfortunately significantly overweight.
“A few years ago, I used to speak to one of his top advisers when he was mayor of London, who personally expressed his concerns about his weight.”
So far there has been no evidence to suggest that people with obesity are more likely to get the virus in the first place.
However, some scientists have said that now is a good time to try to lose weight in light of the pandemic.
Professor Neil Ferguson, an epidemiologist at Imperial College who advises the Government, told The Sunday Times: ‘It is always better to stay fit and healthy.
“We need to assess our risks from a personal perspective, which includes getting fit and losing weight.”