They begin to discover how obesity aggravates COVID-19

In early April, Edna McCloud woke up to find her hands were tied to a hospital bed.

She had spent the past four days shaking and kicking while sedated and on a ventilator at a St. Louis County, Missouri, hospital to combat a severe case of COVID-19.

“They told me it was a true warrior“Recalled McCloud, a 68-year-old African-American pensioner with a history of diabetes and heart problems.

People with obesity are twice as likely to have a fatal outcome when infected (Photo: Obesity Canada)

He weighed about 140 kilos when he contracted the disease, which destroyed his lungs and kidneys.

Almost six months later, she is proud to have overcome the worst. “They say that people with the conditions that I have do not normally survive”, He commented.

As obesity rates continue to rise in the United States, its influence on COVID-19 is a sensitive scientific problem.

A wave of recent studies has proved that overweight people are more susceptible than others to severe episodes of the disease.

Also, in experiments with human and animal cells, it has been shown how excess fat can destabilize the immune system.

However, the relationship between obesity and COVID-19 is complex, and there are many unknowns to solve.

Being overweight tends to go hand in hand with other illnesses, such as hypertension and diabetes, which can make it harder to fight COVID-19.

Obesity also disproportionately affects people who identify as black or latina, who are at a much higher risk than others of contracting COVID-19 and dying from it, largely due to their exposure to the virus in their workplaces, limited access to medical care and other inequalities linked to he systemic racism.

Also, overweight people have to deal with constant stigma related to their appearance and health, even from doctors, which puts their prognosis more at risk.

“A new pandemic is unfolding in addition to the ongoing epidemic,” said Christy Richardson, an endocrinologist at SSM Health in Missouri.

Regarding the effects obesity has on this infectious disease, she noted: “We are still learning, but it is not difficult to understand how the body works. overwhelms”.

The correlation between COVID-19 and obesity is concerning.

Relations

In a study published last month, researchers found that obese people who contracted the virus had more than double likely to end up in the hospital, and that there was a nearly 50 percent chance that they would die from this disease.

Another study, which has not yet been evaluated by experts, showed that of nearly 17,000 patients hospitalized for COVID-19 in the United States, more than 77 percent were obese or overweight

The specialists noted that part of the threat posed by obesity is a mechanical matter: For example, large amounts of fat can compress the lower part of the lungs, making it difficult for them to expand when a person inhales.

It also appears that the blood of obese people is more likely to clot, clogging delicate blood vessels throughout the body and depriving tissues of oxygen.

Fat, or adipose tissue, can also send hormones and other signals that cause nearby cells to go haywire.

“Adipose tissue is very active“Said Rebekah Honce, a virologist at Saint Jude Children’s Research Hospital in Tennessee and the author of a recent analysis describing how metabolism intertwines with immunity.

“It is not a tissue that lacks activity.”

Apparently one of the most powerful effects of fat is suppressing the body’s initial immune response to fight the virus, allowing the pathogen to spread out of control any.

Ultimately, the body’s immune soldiers come together to act together.

But this delayed attack can be more harmful than beneficial: When the cells and immune molecules that are late in arriving are finally activated, they go haywire and provoke uncontrolled episodes of inflammations throughout the body.

These abnormal early responses can also have serious long-term repercussions, said Melinda Beck, who works at the University of North Carolina, Chapel Hill campus, and studies the effect of nutrition on immunity.

Constant inflammation, he noted, can erode the immune system’s ability to generate a long-lived population of “memory” cells, which store information about previous encounters with pathogens.

Similar trends have been observed in elderly patients, who also have trouble assembling effective defenses against pathogens.

When obesity is added, Beck said, some of the immune cells found in 30-year-olds “are similar to those of an 80-year-old.”

Immunity

These problems could have a major effect on early COVID-19 vaccines, Beck said.

If the immune systems of obese people are more likely not to recognize pathogens, then they will require different doses of the vaccine.

Maybe some products do not work not at all in overweight people.

Like many other diseases that can aggravate COVID-19, being overweight does not have an immediate solution, especially in areas where access to healthy food and the ability to exercise are highly uneven within communities.

“If we don’t address this social foundation, I think we will continue to see a recurrence of what is happening now, ”said Jennifer Woo Baidal, a specialist in infant weight management at Columbia University.

In his San Luis County neighborhood, where there have been more than 23,000 coronavirus cases since March, McCloud has had trouble finding fresh products affordable at your grocery store.

Availability has dropped much more since the pandemic started, he says, and what little is on the shelves is almost always on the verge of spoiling.

Within months of McCloud’s illness, his younger sister, Elaine Franklin, 62, began to have terrible headaches.

When he spoke to his family, they asked him why he seemed short of breath. “My son told me, ‘Mom, you have to go to the emergency medical center,’” Franklin recalled. The test immediately revealed that he had also contracted the coronavirus.

Franklin’s COVID-19 case was milder than her sister’s, but it also deteriorated very quickly, to the point that she couldn’t get to the bathroom without help.

“He was so weak, he couldn’t keep his balance,” he said.

Physical symptoms have not been his only difficulty. Franklin, who is overweight, said she was very bothered by the ongoing reports in the news blaming illnesses like the one she suffers from excess fat.

“The way they said it was like, ‘If you’re obese and you didn’t take care of yourself, you’ll get the disease,'” Franklin said. “I feel like that was unfair”.

Even healthcare professionals are biased when caring for overweight patients, said Benjamin Singer, a pulmonologist at the University of Michigan and author of a recent study on the effect of obesity on immunity.

Studies have shown that physicians tend to be more dismissive of obese patients and that they may ignore worrisome symptoms and consider them side effects of being overweight.

Often times, the dosages of medications and diagnostic machines are also discrepant for overweight patients, making it difficult to customize their treatments.

This type of interaction can be a deterrent powerful for some of the people who need more attention.

“These debates are not easy,” said Kanakadurga Singer, a pediatric endocrinologist at the University of Michigan. (She is married to Benjamin Singer). Not all people who weigh more than average are sick, he noted. “It’s not just about numbers and we shouldn’t just focus on weight.”

In St. Louis County, McCloud and Franklin have already recovered, although both sisters continue to struggle with persistent symptoms. McCloud suffers from occasional fatigue and intermittent cough.

“I can’t talk like I used to,” he said. Franklin’s headaches never went away, and now his mind feels clouded.

Both have been concerned for their children, who also contracted the disease: Chris McCloud, who is a teacher, was on a ventilator like his mother and spent several weeks in the hospital shortly before Edna McCloud fell ill. He was also overweight.

Franklin is under the impression that perhaps her son, Darren Catching, who most likely contracted the disease from a former co-worker, caught it.

Franklin commented that she had recently lost a lot of weight and was not hospitalized either, but rather recovered at home.

In July, when Franklin was infected, he sought medical attention twice. She had lupus, an autoimmune disease, and was concerned that she would not be able to fight the virus. Memories of friends and acquaintances who had died of COVID-19 flooded her mind.

However, both times they sent Franklin home; first, from the emergency medical care center, and then from the emergency room of a hospital.

She managed to recover on her own, she said, but still wonders if the exhaustion and foggy mind could have been avoided with more careful clinical care.

“I’m not a doctor or anything like that, but maybe it would have been better if they hospitalized me”.

c.2020 The New York Times Company

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