Covid-19 obesity risk, Kaiser study reveals risk to men and young, Greater risk of death than related factors such as diabetes or hypertension

“Severe obesity puts those with coronavirus disease 2019 (COVID-19) at particularly high risk of death, more so than related risk factors such as diabetes or hypertension, according to a study of patient records that researchers from Kaiser Permanente published today.

The study, appearing in Annals of Internal Medicine,¹ showed that obesity is especially dangerous for men and younger patients who contract COVID-19, and that obesity stood out from racial, ethnic, or socioeconomic disparities when isolated from those factors.

Data from the 6916 patients in the study show that compared with those at normal body mass index (BMI) of 18.5 to 24 kg/m², the risk of death more than doubled for patients with a body mass index (BMI) of 40 to 44 kg/m² (relative risk of 2.68; 95% CI, 1.43 to 5.04) and nearly doubled again for those with a BMI of 45 kg/m² (relative risk of 4.18; 95% CI, 2.12 to 8.26).

“This risk was most striking among those aged 60 years or younger and men,” the authors wrote.

In an accompanying editorial, David A. Kass, MD, a cardiologist at John Hopkins University, wrote that these findings, when taken with prior research, “should put to rest the contention that obesity is common in severe COVID-19 because it is common in the population. Obesity is an important independent risk factor for serious COVID-19 disease.”

“His assessment was stark: COVID-19 makes it hard to breathe, and excess fat only makes this worse.

“As a cardiologist who studies heart failure, I am struck by how many of the mechanisms that are mentioned in reviews of obesity risk and heart disease are also mentioned in reviews of obesity and COVID-19,” Kass wrote. Things like sleep apnea and increased inflammation are all at work, damaging lungs and particularly the air sacs that do the heavy lifting in the respiratory system.

Not only does being severely obese make it harder to breathe, but the adipose tissue fuels mechanisms that act like magnets for SARS-CoV-2, the virus that causes the COVID-19.

“Fat deposited in skeletal muscle may be sought after by top-end steakhouses but, in vivo, it compromises muscle metabolic efficiency, nutrient uptake, and performance,” Kass wrote. “It requires more muscle force to displace the diaphragm downward when a substantial fat mass lies below it. Abdominal obesity also makes it more difficult to breathe in a prone position that is favored to improve ventilation in patients with COVID-19.””

Read more:

https://www.ajmc.com/view/kaiser-severe-obesity-boosts-risk-of-covid-19-death-especially-for-the-young