risk factor for chronic comorbidities of COVID-19

Katherine Trujillo Useche

Latin Agency for News of Medicine and Public Health

Obesity is defined as a high level of body fat in relation to height, this means that someone’s weight is greater than what is considered healthy for their height. According to the World Health Organization, the obese population has increased by 39% in adults around the world from 1975 to 2019.

When the COVID-19 pandemic began, and with it the first infections, doctors noticed that the people who became seriously ill from COVID-19 were mostly obese. This is why the link became clearer as COVID-19 spread around the world, leading to the accumulation of data. Researchers are still trying to determine the exact reason behind this.

However, being overweight is known to boost the chances of developing various health problems that include heart and respiratory diseases, these are among the main diseases that can put coronavirus patients at greater risk of being seriously affected.

The causes behind this exponential increase in overweight and obesity are, on the one hand, excessive consumption of foods high in calories and rich in fat and, on the other hand, low physical activity as a consequence of sedentary work, the new means of transport and urbanization.

According to data from the Organization for Economic Cooperation and Development (OECD) of 2017, the countries with the largest population with obesity or overweight is America with Chile, Mexico and the United States being the one with the largest obese population, these three countries exceed the 70%. The best positioned countries are Asians, specifically South Korea and Japan. The data extracted also shows that, with the exception of the United States and Israel, it is Europe where the proportion of people who admit to being overweight is closer to the real figure.

There is evidence that obesity itself can increase the chances of severe complications of the disease. COVID-19 virus. A study carried out in more than 5,200 patients infected with coronavirus showed that 35% of those affected were obese and it was found that the probabilities of hospitalization increased for people with a high body mass index, even taking into account other problems that could put them in risk. Scientists are still studying how obesity affects the immune system.

Obesity may be the reason why some countries or communities have been more affected during the pandemic than others, say some studies. In the United States, the obesity rate among adults has risen for decades, now it is 42%, and it is even higher among blacks and Hispanics.

Scientists suggest that multiple factors make it difficult for obese people to fight off the coronavirus, as it damages the lungs. Excess weight puts pressure on the body, and that excess body fat can limit the lungs’ ability to expand and breathe.

Another problem that scientists highlight is chronic inflammation that is often accompanied by obesity. Inflammation is the body’s natural way of fighting harmful intruders like viruses, but extensive inflammation is unhealthy and can weaken the body’s defenses when a real threat appears.

“It’s like throwing gasoline on a fire,” says Dr. Dariush Mozaffarian, dean of the School of Nutrition at Tufts University, Boston. “Even if obese people do not have a diagnosis of diabetes or heart disease, health may not be optimal” concludes the doctor.

The way in which fat is distributed in the body may play an important role, as a study found a high risk of death from COVID-19 in people with severe obesity, but only among men. This may reflect the fact that men tend to have excess lipids in the stomach area, said Dr. Sara Tartof who is a co-author of the infectious disease study for Kaiser Permanent in California.

“This type of fat is more associated with the production of a hormone that can contribute to a more serious disease,” he concludes.

Researchers explore the possibility that there is something specific about the COVID-19 virus that makes obese people more susceptible to becoming severely ill.

“The virus infects cells by attaching itself to receptors on the surface of some cells, this receptor is abundant in adipose cells and experts are studying whether this makes a good nest for the virus,” said Dr. Francois Pattou, who has worked on studies on the obesity nexus and severe manifestations of COVID-19.

There can also be complications in medical care once the patient is hospitalized. To help with breathing, doctors place the coronavirus patient face down in beds, but this can be difficult for obese patients so they are likely to be hooked up to artificial respirators.

An additional concern is that the coronavirus vaccine may not be as effective for obese people as vaccines for influenza and other diseases. “The reason is still unknown, but one possibility is that obesity hinders an aspect of the immune system that has to be activated for vaccines to work,” concluded Dr. Nancie MacIver of Duke University.

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