With the novel coronavirus pandemic sweeping across the globe and the nation many are looking for answers as to who is at risk. In the United States alone many individuals, 50 years of age or younger, have been impacted and some have even fallen victim to the virus. New studies are suggesting that obesity may be a significant predictor of severe COVID-19 illness. These findings are both alarming and important because the United States has one of the highest obesity rates in the world. According to the Centers for Disease Control & Prevention 40% of American adults, about 80 million people, are struggling with obesity. Obesity effects both the young and old, meaning even younger adults are at high risk of contracting the virus and succumbing to its negative effects.
A study conducted out of NYU Langone by the director of the Center for Healthcare Innovation and Delivery Science, Dr. Leora Horowitz, shed light on this finding. Dr. Horowitz explained, “Obesity is more important for hospitalization than whether you have high blood pressure or diabetes, though these often go together, and it’s more important than coronary disease or cancer or kidney disease, or even pulmonary disease.” She also explained that obesity appears to be a primary risk factor for becoming sick enough to die from COVID-19.
Chinese doctors have found that patients with a higher BMI were at more than double the risk of severe pneumonia compared to those with a lower BMI. One of their studies focused around a group of 112 patients, 17 of those patients died from the virus and of those 17, 15 of them were overweight or suffering from obesity.
In light of these findings, several doctors are speaking out. Doctors like Dr. Leo Seone, with the Oschsner Health Care System in Louisiana and Southern Mississippi, has explained that nearly 60% of their patients hospitalized with the virus have obesity and their chances for requiring a ventilator are doubled compared to individuals who do not have obesity. Others like Dr. Matthew Hutter, director of the Weight Center at Massachusetts General Hospital and president of the American Society for Metabolic and Bariatric Surgery, say “We in the U.S. have not always identified obesity as a disease, and some people think it’s a lifestyle choice. But it’s not, it makes people sick, and we’re realizing that now.”
Additionally, of the 14 patients currently being treated at Dr. Sanam Ahmed’s critical care unit in Mount Sinai in the Upper East Side of New York, 12 are at least 50 years of age with complex medical problems, but 2 of them, in their 30’s, were simply obese, no other disease was present. Dr. Ahmed said, “It looks like, for them, obesity is the risk factor.”
Several hypotheses exist that attempt to explain how obesity worsens the COVID-19 disease. Most notably, according to health experts, obesity is a well-known contributor to overall inflammation in the body that impacts immune health. Cytokines are pro-inflammatory proteins that may lead to a ‘cytokine storm,’ even among younger COVID-19 patients, this is a major contributor to sepsis and subsequently death. Men disproportionally carry weight around their waist and around their organs and that pushes against the diaphragm, lungs, and decreases lung capacity. As an underlying contributor to many other chronic diseases, obesity can also lead to grim outcomes for someone who otherwise would be spared if they were within their normal weight range.
As the experts learn more about how COVID-19 manifests itself in the U.S. additional risk factors will continue to be identified even among varying population subgroups. It is well known that obesity disproportionately impacts people of color alongside other conditions such as high blood pressure, high cholesterol, and type 2 diabetes. For instance, during this pandemic, new research is unveiling that the African American community is significantly impacted due to the COVID-19 disease.
It is clear that with more underlying chronic diseases, some communities will definitely encounter health disparities that lead to worse outcomes; however, by identifying these risk factors, health experts, medical professionals, and policymakers will have more evidence in order to execute data-driven decisions and implement targeted public health strategies and messages.
References: Obesity Linked to Severe Coronavirus Disease ... - nytimes.com. (n.d.). Retrieved April 20, 2020, from https://www.nytimes.com/2020/04/16/health/coronavirus-obesity-higher-risk.html Yancy, C.W. (15 April, 2020). COVID-19 and African Americans. Journal of American Medical Association. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2764789