Researchers have found that apart from pre-existing medical conditions such as high blood pressure and respiratory disease, obesity is a major risk factor for COVID-19 hospitalization.
As COVID-19 patients first began arriving at Johns Hopkins Hospital in Baltimore in March, cardiologist Dr. David Kass was surprised to hear about the observations from his colleagues in the ICU.
First, he saw patients were much younger than expected in contrast to the reports from China and Italy that the coronavirus was mostly endangering older people. Second, most patients in Baltimore were obese.
Dr. Kass said, “Even based on about 20 patients at first, the finding was already significant. But at the time you could do a Google search of ‘COVID-19 and obesity’ and you got basically nothing.”
This month, Dr. Kass and two colleagues looked at preliminary findings from six ICU units across the United States. They wrote, “In populations with a high prevalence of obesity, COVID-19 will affect younger populations more than previously reported.”
In the United States, the risk is particularly high due to an increased prevalence of obesity (40%), compared to China (6%) and Italy (20%).
Since the findings, the topic of obesity has started gaining more attention. A New York Times editorial by two doctors noted that obesity is a potential factor with the eruption of severe COVID-19 cases in New Orleans.
Dr. Kass told The Hub, “Our data show that if you are younger and you end up in the hospital with COVID-19, it is more likely that you are obese.”
He explained that younger patients are less likely to have other co-morbidities such as diabetes, hypertension, or heart disease, so obesity could be the primary factor that affects their COVID-19 course.
Explaining why the coronavirus risk is higher among obese people, Dr. Kass said it is based on physics. People with substantial obesity, with BMI over 35, carry excess weight mostly in their abdomen, below the diaphragm, which can make breathing difficult while moving your diaphragm toward your feet. This is what happened with any respiratory disease.
He when on to say that with COVID-19 infection, the lung airway sacs and blood vessels surrounding them become leaky, “allowing fluid to enter the airways.” This makes it hard for a person to get oxygen from the air to the blood, eventually making the diaphragm to work even more, and obesity restricts this.
Dr. Kass said another factor is the inflammation. Adipose tissue to fat produces a number of pro-inflammatory molecules known as cytokines. Experts have raised concerns over the increasing number of obesity issues in the United States. Dr. Kass thinks that it is important to obesity seriously as a pre-existing medical condition, which can increase your risks for COVID-19.
