Obesity Doubles Risk of Covid-19 Patients Requiring Mechanical Ventilation

RIO DE JANEIRO, BRAZIL – Those infected with Covid-19 are twice as likely to need mechanical ventilation if they are obese, and twice as likely to be hospitalized if they have had radiation therapy for cancer in the past year, according to the first broad data on the deterioration of coronavirus patients coming in to hospitals.

The Spanish Society for the Study of Obesity (SEEDO) has summarized the scientific evidence published to date and the relationship is clear: overweight or obese people infected with the coronavirus have worse survival rates and a worse development than other patients, comments Francisco Tinahones, president of the society.

In China, an early study estimated that 88 percent of those killed by Covid-19 had a body mass index (BMI, a value obtained by dividing a person’s weight in kilograms by the square of their height in meters) higher than 25, the limit between being overweight and being obese.

This percentage is higher than the average of overweight or obese people in the country, which is approximately 54 percent of the population. Among the survivors, 91.1 percent were below this figure.

Furthermore, a French study, the most relevant on the subject so far, determined a correlation between overweight and obesity with the need to use ventilators in people with Covid-19. The result was that 75 percent of those who needed this treatment, which occurs when coronavirus pneumonia progresses and is severe, were overweight or obese (in France as a whole, according to OECD data, about 50 percent of the population suffer from this condition) and their need for ventilators was as much as double that of those affected.

Tinahones believes that there are two factors behind this incidence. The first is physical: the obese breathe poorly since their own weight hinders the operation of the muscles that should help the lungs.

But there is a biological factor that he believes should be closely observed: the adipose tissue cells, popularly known as body fat, have a high level of a specific protein in their membranes, the ACE2, which is known to be the entry route of the coronavirus into the cells of the respiratory system it infects.

Thus, Tinahones believes that in overweight or obese people this tissue can act as a reservoir of Covid-19, making it difficult to eliminate it and facilitating the affected individuals to remain as sources of contagion for longer periods of time.

Tinahones points out that one of the possible causes of the difference in infection in Spain and Italy, when compared to South Korea and China, to name two countries with much lower mortality, could be the prevalence of overweight and obese populace.

For instance, in South Korea, about one-third of the population is overweight or obese, while in Spain, according to data from the Ministry of Health, 53 percent of adults are affected (the percentage increases with age and reaches 63 percent among those over 65, which is when Covid-19 is most dangerous).

Other relationships that start to be quantified are the deterioration of those infected by the virus because they have undergone chemotherapy or had a stent implanted (an extensible device similar to a small spring that keeps the arteries open after heart failure).

Sanitas insurance company conducted a curious study comparing some health conditions in 675 of the nearly 4,000 people treated for Covid-19, according to Domingo Marzal, medical director of the company’s hospital division. The probability of hospitalization of those with some condition was evaluated compared to the group of patients they treated, using data from those over 60.

Thus, they found that having had radiation therapy multiplied the risk by two; having implanted a stent in the past 12 months multiplied it by four, and having undergone surgery or respiratory therapy multiplied it by five.

Marzal accepts that this is not a study in the strict sense, but considers that the difference between the percentage of those affected who were admitted without having these conditioning factors and those who have them, is so great that it confirms the relationship between these pathologies and the development of coronavirus infection, as well as providing an idea that the effect is not minor, but rather very significant.

Source: El País