“8 out of 10 people who developed severe forms of COVID-19 were obese”: risk factors go well beyond age
During much of the pandemic, the forest has not let us see the trees. The healthcare pressure on hospitals, mortality at record highs and the lack of specialized treatments made saving the most vulnerable a priority even though we knew there were many more behind them.
Now that the vaccine is removing the groups that had suffered the hardest out of the equation, we are confirming something that we already knew: that the “old-young” dichotomy captured a very small part of the story, that the risk related to COVID -19 was much more spread out than it might seem. The clearest case is undoubtedly obesity.
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An increasingly important problem
Something known, but invisible: In this sense, the data from the Spanish Obesity Society seem resounding: It is not only that people with obesity have a higher risk of becoming infected, but that have a worse progression and higher rates of hospitalization. There are also higher rates in ICUs which is related to a higher risk of mortality.
8 out of 10: According to Susana Monereo, Head of the Endocrinology Service of the Gregorio Marañón Hospital in Madrid, 80% of patients admitted to hospitals in the country who have developed severe forms of COVID had obesity. Let us remember that, although 60% of the adult population is overweight, only 21% meet the criteria for obesity.
However, and despite the high volume, the truth is that it is not a particularly surprising data. Obesity is linked to type 2 diabetes, high blood pressure, and numerous cardiovascular diseases. Diseases all of them that we know are related to a worse prognosis of the disease. Other pathologies associated with obesity (such as nonalcoholic steatohepatitis) seem to be a risk factor for the spread of the disease.
Why? As it is tradition in these matters, there are many things that we still do not know. From the outset, we are not clear about the mechanism that makes obesity one of the major risk factors for the disease. The researchers are working on models that associate this problem with the character of a “chronic state of low-grade inflammation” that characterizes obesity or with reduced immunity that also often appears in obesity.
This would imply from a lower capacity of the body to fight the virus to a poor immune response that would imply (even) a lower efficacy of the vaccines. Yes, for now explanations are just theories, while data is a troubled reality. In fact, other researchers associate it with the risk of thrombosis or with the reduction in the inspiratory reserve volume associated with abdominal obesity.
A major problem: Be that as it may, these data are a warning to sailors now that the epidemiological situation improves and restrictions are lifted. Unless a variant appears capable of escaping the vaccine, we will not see situations like last year. However, the epidemic is still very much alive and in many countries this has resulted in an increase in cases among the youngest who (partly from pandemic fatigue, partly from a false sense of security) engage in more risky behavior.
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