- Researchers have identified several coronavirus risk factors that can make COVID-19 worse.
- Cancer, heart disease, diabetes, weak immune system, and obesity are among the medical conditions that could result in life-threatening complications.
- Researchers have isolated obesity from other comorbidities and factors and found the medical condition is extremely dangerous for men under 60 who get infected with the novel virus.
The elderly, the immunocompromised, and people with other medical conditions are the ones at the greatest risk of life-threatening complications after infection with the novel coronavirus. But that doesn’t mean everyone else is safe. There are plenty of exceptions, and that’s why everyone needs to be careful.
Still, it’s people with major comorbidities who should do everything they can to avoid contracting the illness. Factors like cancer, diabetes, heart disease, and obesity can result in severe COVID-19 cases. The virus also kills more men than women, and age plays a role. But in a surprising new study, researchers determined that one of the most-discussed COVID-19 risk factors, when presented in its pure form, kills more men younger than 60 than it does women.
Researchers from the Kaiser Permanente Southern California Health System combed through nearly 7,000 cases to determine the impact of obesity on COVID-19 prognosis. Published in Annals of Internal Medicine, via MSN, the study explains that researchers eliminated all the other comorbidities and other factors associated with obesity, and determined that obesity, as a single medical condition, is more dangerous for men up to 60.
The study concluded that “extremely obese” people with a BMI index of 40 or more were nearly three times more likely to die of COVID-19 than people of average weight. Those with a BMI of 45 were over four times more likely to die. But the risk was “most striking among those aged 60 years or younger and men.”
The researchers used the available data to isolate obesity from other medical conditions and other socioeconomic factors. They even adjusted their findings for time, knowing that each week into the pandemic allowed healthcare workers and public health officials to change the response to better treat COVID-19 and prevent the spread.
The purpose of the study was to determine the direct effects of obesity on COVID-19 prognosis before patients develop other obesity-linked conditions like diabetes and heart disease that can worsen with age.
“We present findings that can inform decisions much earlier in the triage process, including in the ambulatory setting,” they wrote. “Our finding that severe obesity, particularly among younger patients, eclipses the mortality risk posed by other obesity-related conditions, such as history of myocardial infarction, diabetes, hypertension, or hyperlipidemia, suggests a significant pathophysiologic link between excess adiposity and severe COVID-19 illness.”
John Hopkins University cardiologist Dr. David A. Kass wrote an accompanying editorial explained why obesity is a higher risk factor in men under 60. “The risks are higher in younger patients is probably not because obesity is particularly damaging in this age group; it is more likely that other serious comorbidities that evolve later in life take over as dominant risk factors,” he said.
One of the simple reasons why obesity can worsen COVID-19 has to do with the way fat builds up around the abdomen. “It requires more muscle force to displace the diaphragm downward when a substantial fat mass lies below it,” the doctor explained. “Abdominal obesity also makes it more difficult to breathe in a prone position that is favored to improve ventilation in patients with COVID-19.”
Moreover, fat has higher levels of ACE2 protein than the lungs. The virus binds to those receptors and may take refuge in the fat and use it as a replication site, prolonging infectivity.
The researchers also noted that fighting COVID-19 might be the priority, but obesity also needs to be addressed. “Our findings also reveal the distressing collision of 2 pandemics: COVID-19 and obesity,” they wrote. “As COVID-19 continues to spread unabated, we must focus our immediate efforts on containing the crisis at hand. Yet our findings also underscore the need for future collective efforts to combat the equally devastating, and potentially synergistic, force of the obesity epidemic.”
Kass said that “severe and morbid obesity is sufficiently common in the United States to have become part of our social fabric,” and that may make COVID-19 messaging difficult. He noted that rapid weight reduction isn’t possible to reduce the risks. “Therefore, social distancing; altering behaviors to reduce viral exposure and transmission, such as wearing masks; and instituting policies and health care approaches that recognize the potential effects of obesity should be implemented,” he said. “These actions should help and are certainly doable.”