Three new studies describe the link between obesity and increased risk of COVID-19 infection and poor outcomes.
The first study, published yesterday in Diabetes Care, shows that especially black hospitals COVID-19 patients with metabolic syndrome (a combination of obesity, high blood pressure, diabetes, and / or abnormal cholesterol levels that increase the risk of cardiovascular disease) were almost five times more likely than their peers needed intensive care and experiencing a ventilator or breathing and dying 3.4 times more often from their infections.
The more of the diagnosis of metabolic syndrome patients had, the worse their prognosis. While patients who had only one of the diagnoses were less likely to die than their peers, obesity and diabetes were associated with increased chances of intensive care and a ventilator. High blood pressure alone was not linked to a single negative outcome.
Increased need for growth
“The underlying inflammation seen with metabolic syndrome may be the driver leading to these more serious cases,” lead author Joshua Denson, MD, MS, said in a Tulane University press release. “Metabolic syndrome should be considered as a composite predictor of COVID-19 lethal outcome, increasing the chance of mortality due to the combined effects of its individual components.”
The researchers checked 287 coronavirus patients who were hospitalized in New Orleans from March 30 to April 5, which coincided with the pandemic peak in that city. Of the 287 patients, 188 (66%) had metabolic syndrome. Compared to their peers, a higher rate of patients with metabolic syndrome requires care in an intensive care unit (ICU) (56% vs. 24%), needing a ventilator (48% vs. 18%), developing acute respiratory distress syndrome (37% against 11%), and died (26% against 10%).
Mean age for patients was 61 years, almost 57% were women, and more than 85% were black. Their most common underlying conditions were high blood pressure (80%), obesity (65%), diabetes (54%), and low levels of high-density (“good”) cholesterol lipoprotein (39%).
Denson said in the press release that people with metabolic syndrome should be especially vigilant in preventing exposure to COVID-19. “It does not matter if you are young or old – we have taken that into account,” he said. “You would have to be really extra careful. I would say it affects both the occurrence of your exposures, and if you get sick, you should probably see your doctor sooner.”
Decreased ability to fight infection
The second study, a systematic review and meta-analysis of 75 Chinese and English language studies on obesity and COVID-19 published today in Obesity Reviews, found that obese people were 1.5 times more likely to be infected with coronavirus than their non-obese peers, 2.1 times more likely to be hospitalized for their infections, 1.7 times more likely to be admitted to an ICU, and 1.5 times more likely to be admitted to an ICU. more often die from the virus.
The researchers said that obesity-induced metabolic changes such as inflammation and limited ability to use insulin can interfere with the ability to fight infections such as flu and hepatitis. Also, infection can lead to uncontrolled blood glucose in patients with diabetes, which can impair the immune response.
“People with obesity are also more likely to have physical illnesses that make fighting this disease harder, such as sleep apnea, which increases pulmonary hypertension, or a body mass index that increases difficulties in a hospital setting with intubation,” co-author Melinda Beck, PhD, of the University of North Carolina at Chapel Hill said in a university press release.
The authors said they were concerned that a COVID-19 vaccine might be less effective in people with obesity, as is the case with influenza vaccine, which should be taken into account when testing vaccine candidates.
Lead author Barry Popkin, PhD, also of the University of North Carolina, said in the release that the pandemic has caused further slides in physical activity and the ability to access and pay for healthy foods.
“Not only are we more at home and experiencing more stress due to the pandemic, but we also do not visit the grocery store as often, which means the demand for highly processed junk foods and sugary drinks that are less expensive and more shelf-stable has increased, “said Popkin. “These cheap, highly processed foods are high in sugar, sodium and saturated fat and loaded with highly refined carbohydrates, all of which increase the risk of not only excess weight gain, but also important non-communicable diseases.”
He called on governments to implement strong public health policies to reduce the prevalence of obesity, such as warning labels on foods high in sugar, fat and salt, and restricting the marketing of unhealthy foods to children. “Given the significant threat COVID-19 poses to individuals with obesity, healthy eating policies can play a supportive – and especially important – role in mitigating COVID-19 mortality and disease,” Popkin said.
Higher risk of infection
In the third study, researchers in South Korea discovered that higher levels of obesity were associated with increased risk of COVID-19 infection. Compared to healthy weight control subjects, overweight adults were 1.1 times more likely to contract coronavirus, and obese people were 1.3 times more likely.
Published yesterday in Clinical infectious diseases, the case-control study of 3,788 COVD-19 patients and 15,152 matching controls from 24 January to 9 April showed that the association between obesity and increased risk of infection was true even after adjusting for sociodemographic factors, the presence of underlying medical conditions , laboratory values, and the use of medicines.
“As the COVID-19 pandemic evolves, ongoing research into the interaction between metabolic health, particularly obesity, and the risk of COVID-19 are warranted to inform control strategies for COVID-19,” the authors wrote. “Waiting for further evidence supporting causal relationship between obesity and the risk of COVID-19 infections, individuals with a higher [body mass index] could potentially be classified as high risk and thus, prioritized in COVID-19 tests. “
