E-Paper
Study links obesity to severity of disease, death in young patients
BMI is a measure of wether a person is overweight or underweight, calculated by dividing the weight in kilograms by the square of the height in metres.
Obesity has been identified as a risk factor for the coronavirus disease (Covid-19)among people aged below 60 and is likely to lead to more severe forms of the disease and death among the overweight, a new study suggests.
Patients with a body mass index (BMI) of 30 to 34 were twice more likely to be hospitalised and 1.8 times more likely to need critical care and those with a BMI of >35 were 2.2 times more likely to get hospitalised and 3.6 times more likely to need critical care compared to those with a BMI of <30.
BMI is a measure of wether a person is overweight or underweight, calculated by dividing the weight in kilograms by the square of the height in metres.
The findings on the impact of obesity on people identified as Coiv-d19-positive were based on a study 3,615 patients who visited a large hospital in New York. Of them, 21% had a BMI of 30 to 34 (obese) and 16% had BMI of >35 (bordering extreme obesity). Of the total, 37% had to be hospitalised and 12% needed critical care. The study has been accepted for publication in the Oxford journal of Clinical Infectious Diseases on April 9.
“Though patients under 60 years are generally considered a lower risk group for Covid 19 disease severity, based on data from our institution, obesity appears to be a previously unrecognised risk factor for hospital admission and critical care,” the study said.
The study also briefly refers to the fact that obesity could be an important factor explaining high mortality in the US compared to, for instance, China and South Korea.
South Korea, China, US and Italy have a fatality rate of 2.2%, China 4%, US 4.9% and Italy 13.1% presently as per Johns Hopkins University data analysis.
New York is presently the epicentre of the pandemic, with over 10,913 deaths, according to Johns Hopkins University data. Another study by NYU Langone Health, an academic hospital ,published in Medrxiv, a website for pre-print studies on April 11, found that among 4,103 Covid-19 patients studied, the most at risk were those older than 75 years and those with a BMI over 40 (severe obesity). People with a heart condition and those with oxygen saturation of less than 88%, and high markers of inflammation, were others at high risk.
Around 28.1% hospitalised patients, according to the NYU Langone study, needed invasive ventilation and 18.5% died, compared to 2.3% patients needing invasive ventilation and 1.4% dying in the largest study of 1,099 hospitalised Covid-19 patients in China.
“It is notable that the chronic condition with the strongest association with critical illness was obesity, with a substantially higher odds ratio than any cardiovascular or pulmonary disease. Obesity is well-recognized to be a pro-inflammatory condition,” the study said.
Obesity was high among patients admitted in intensive care units and the disease’s severity increased with BMI, found a tudy by researchers at the Centre Hospitalier Universitaire de Lille in France of 124 Covid-19 patients .
“Obesity is linked to pre-diabetes, diabetes, hypertension, low immunity, sleep apnoea, heart disease, obesity hypoventilation syndrome which all increase susceptibility and adverse outcomes in diseases like Covid-19,” said G C Khilnani, chairman of the PSRI Institute of Pulmonary and Critical care in New Delhi, and former head of pulmonology at the All India Institute of Medical Sciences (AIIMS)
Obesity predisposes people to many diseases and infections, . said Dr Romel Tickoo, consultant of internal medicine at Max Hospital.
“If obese persons are on ventilator support, its difficult to wean them off because they have some sort of obstructive sleep apnoea. They tend to retain carbon dioxide. They also have pre-diabetes or diabetes and hypertension,” he said, adding that inflammatory markers predisposes them to morbidity.
