Obesity and Covid-19 Patients: Clinical Observations

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Shuvomoy Banerjee, PhD; from Neucrad Health desk; Sept. 21, 2020

The novel Coronavirus pandemic has so far killed more than nine million people. The current studies and data statistics now showing that obese Covid-19 patients has higher mortality rate!

According to the data obtained, obese people with COVID-19 are 84% more likely to be admitted to the Intensive Care Unit (ICU) than the average person with COVID-19, and out of which 48% become critically ill and die. Physicians and scientists agree that obesity is a leading cause of death in Covid-19. Before we discuss the connection of Obesity with Covid-19 in detail, we first need to understand Obesity.

Obesity:

Obesity is a disease in medical science. Obesity causes an abnormal increase in body size and weight. Obesity can be caused by a variety of factors, such as:

  • Lack of a balanced diet
  • Sedentary lifestyle
  • Excessive alcohol consumption
  • Stress and/ depression
  • Genetic factors
  • Hormonal problems and
  • Various complex metabolic disorders.

Obesity can be referred to a condition where the body begins to accumulate fat at an abnormal rate and in a chronic way. Such Chronic obesity causes all kinds of serious illnesses, disrupts normal movement of people, reduces performance, and can lead to mental and nervous problems. Of note, the real question is how to measure obesity!

Measuring Obesity and Body-Mass Index (BMI):

There are scientific ways to do this. Dividing a person’s body weight (in kg) by the square of his height (in meters) gives the body-mass index or BMI.

Henceforth, BMI = kg / m2

Importance of BMI lies in the fact that if the calculated BMI is more than 25.0, the person is considered obese and if it lies between 18.5 to 24.9 BMI values, then healthy!

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Relationship of various diseases with obesity:

Prolonged obesity can lead to high blood pressure, lung problems, stroke, cancer, neuro-inflammatory diseases, type-2 diabetes, osteoarthritis, coronary thrombosis, and mental depression. Obesity is directly related to so many diseases by directly hampering the body physiology as follows-

  1. Chronic physical obesity causes fat to build up in the muscles below the diaphragm and the diaphragm to move slightly upwards. This puts pressure on the lower part of the lungs, reducing blood flow to that part, resulting in shortness of breath and various lung diseases.
  2. Research indicated that in case of obesity, blood clots easily and forms blood clots, which in most cases lead to stroke.
  3. Interestingly, Obesity causes the release of various cytokines from adipose cells (fat cells) that accumulate in the body, increasing the levels of pro-inflammatory cytokines in the blood and causing inflammatory diseases.
  4. Scientific studies show that in obesity, the body’s adipose tissue often replaces immune cells (tonsils, lymph nodes, pair’s patches, etc.), meaning it wants to take its place. This causes the body’s immunity to decline and bacterial infections to begin.

The link between Obesity and Covid-19:

We know that the condition of a patient with Covid-19 becomes critical mainly for three following reasons:

1) Severe infection and pneumonia in the lower part of the lungs by Novel Coronavirus.

2) Creation of “cytokine storm” in the body which paralyzes various important organs.

3) The effects of infection cause blood clots in the blood vessels and cause stroke.

                       Importantly, obesity of a patient with COVID-19 will affect the lower lobe of the already infected lungs even more, resulting in rapid spread of SARS-CoV-2 infection and severe pneumonia. Moreover, cytokines such as TNF-a, IL-6, TGF-b etc. secreted continuously from adipose cells spread throughout the body via bloodstream. In case of patient with Covid-19, these pro-inflammatory cytokines increase dramatically, creating a “cytokine storm” that rapidly disrupts the vital functions of various organs, leading to “multi-organ failure.” Interestingly, Scientists have found that obese people don’t demonstrate the usual and normal T-lymphocyte immune response to SARS-CoV-2 infection. In addition, there is a tendency for blood clots to form (in the blood vessels) not only in case obesity but also in case of Covid-19 infection (inside the internal organs), therefore, greatly increasing the risk of SARS-CoV-2 infected patients towards stroke!

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Tips to Get Rid of Obesity:

  • Diet changes- Obesity is reduced by taking certain balanced meals at regular time intervals in a day. One should eat certain calorie foods only as per the age, weight, height after consultation with physician. The diet should be high in vegetables and protein and low in carbohydrate foods. Importantly, Sugary and fatty foods should be eaten as little as possible.
  • Getting rid of stationary lifestyle- One must come out of their stagnant life and must dedicate a certain amount of their time to walk and exercise daily.
  • Mental preparation and/ counseling- Obesity for a long time needs lot of mental preparation to bring changes in body weight and lifestyle. This can be done with own determination and if required, taking a counselor’s help.
  • Prescribed Medicines and Surgeries- If there is an emergency and difficulty in someone’s body physiology as a result of chronic obesity, specific medicine and surgery may be recommended by doctors.

Obesity is already known to be a physical and physiological disorder. Recently found connection of Covid-19 mortality to obesity has once again increased the worries related to Obesity. Time has come that we check our BMIs and follow healthy diet as well as exercises, so as to fight against numerous diseases including Covid-19!

References:

  1. Caussy C, Wallet F, Laville M, Disse E. Obesity is Associated with Severe Forms of COVID-19. Obesity (Silver Spring). 2020 Jul;28(7):1175. doi: 10.1002/oby.22842. Epub 2020 May 21. PMID: 32314861; PMCID: PMC7264509.
  2. Dietz W, Santos-Burgoa C. Obesity and its Implications for COVID-19 Mortality. Obesity (Silver Spring). 2020 Jun;28(6):1005. doi: 10.1002/oby.22818. Epub 2020 Apr 18. PMID: 32237206.
  3. Caci G, Albini A, Malerba M, Noonan DM, Pochetti P, Polosa R. COVID-19 and Obesity: Dangerous Liaisons. J Clin Med. 2020;9(8):2511. Published 2020 Aug 4. doi:10.3390/jcm9082511
  4. Petrakis D, Margină D, Tsarouhas K, Tekos F, Stan M, Nikitovic D, Kouretas D, Spandidos DA, Tsatsakis A. Obesity ‑ a risk factor for increased COVID‑19 prevalence, severity and lethality (Review). Mol Med Rep. 2020 Jul;22(1):9-19. doi: 10.3892/mmr.2020.11127. Epub 2020 May 5. PMID: 32377709; PMCID: PMC7248467.
  5. Dugail I, Amri EZ, Vitale N. High prevalence for obesity in severe COVID-19: Possible links and perspectives towards patient stratification [published online ahead of print, 2020 Jul 8]. Biochimie. 2020;S0300-9084(20)30155-3. doi:10.1016/j.biochi.2020.07.001
  6. Yadav R, Aggarwal S, Singh A. SARS-CoV-2-host dynamics: Increased risk of adverse outcomes of COVID-19 in obesity. Diabetes Metab Syndr. 2020;14(5):1355-1360. doi:10.1016/j.dsx.2020.07.030
  7. Lockhart SM, O’Rahilly S. When Two Pandemics Meet: Why Is Obesity Associated with Increased COVID-19 Mortality? [published online ahead of print, 2020 Jun 29]. Med (N Y). 2020;10.1016/j.medj.2020.06.005. doi:10.1016/j.medj.2020.06.005

                                          

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