Obesity and Covid-19: Why is obesity an aggravating factor?
Obesity and Covid-19 “We did not know early on what a critical risk factor obesity was. … It’s not until more recently that we’ve recognized the crushing influence of obesity, especially in younger people,” says Anne Dixon, a physician-scientist who studies obesity and lung disease in the University of Vermont. This”could be one reason behind its catastrophic impact of COVID-19 from the USA, where 40 percent of adults are overweight.”
Since the pandemic began, dozens of studies have also reported that a number of the sickest COVID-19 patients happen to be people with obesity. Lately, that relationship has come into better focus as big new inhabitants’ studies have cemented the institution and demonstrated that people that are merely overweight are at greater risk.
Obesity is a common, serious, and costly chronic disease. Having obesity puts people at risk for many other serious chronic diseases and increases the risk of severe illness from COVID-19. Everyone has a role to play in turning the tide against obesity and its disproportionate impact on racial and ethnic minority groups.
Why COVID-19 is more deadly in obese people?
The physiological pathologies that return people with obesity vulnerable to severe COVID-19 begin with mechanisms: Fat from the abdomen pushes upward on the diaphragm, leading to that significant muscle, which is situated under the chest cavity, to impinge on the lungs and restrict airflow. This diminished lung volume leads to failure of airways from the lower lobes of the lungs, where more blood happens for oxygenation than in the upper lobes. “In case you’re already beginning with this mismatch, then you are going to get worse faster” from COVID-19, Dixon says.
Other issues compound these mechanical problems. For starters, the bloodstream of people with obesity comes with an increased tendency to clot a particularly grave threat during an illness that, when intense, independently peppers the small vessels of the lungs with Illness (Science, 5 June, p. 1039). In healthy people, “the cells which line the blood vessels are often stating to the surrounding blood: ‘Do not clot,”‘ says Beverley Hunt, a physician-scientist who’s a specialist in blood clotting at Guy’s and St. Thomas’ hospitals in London. But “we believe that signaling was affected by COVID,” Hunt says, since the virus injures endothelial cells, which react to the insult by activating the coagulation system.
Improved Production of Cytokines
A corollary of maintaining excess fat in non-adipose tissue would be that the adipose tissue has attained or is reaching the limits of its capacity to store fat safely. If elevated inflammation leads to alveolar damage, then that provides an obvious possible route whereby the metabolic risk factors could drive increased mortality.
Modified Adipose Tissue Hormones
Adipose tissue growth not only results in the elaboration of inflammatory cytokines but it also affects the profile of hormones that are secreted. A key signature of insulin resistance is a rise in the ratio of circulating leptin and adiponectin. Obesity is associated with higher circulating leptin and decreased circulating adiponectin.
Thrombosis
Venous thromboembolism costs are much greater in patients with severe COVID-19 than critically ill controls, and there’s growing evidence of high levels of thrombotic microangiopathy in severe COVID-19. Obesity is a confirmed risk factor for arterial and venous thrombosis, and dysfunction of the endothelium, platelets, fibrinolytic system, along with the clotting cascade are implicated.
Insulin Resistance, Not Fat Mass, Is Explanation to the Link between Obesity and Poor COVID-19 Outcomes
When it’s the case that insulin resistance, not fat mass, is the explanation to the correlation between obesity and insufficient COVID-19 outcome, then this is in fact critical, as even short-term low carb diets may improve insulin sensitivity in days.
As obesity has become almost omnipresent and no vaccine for COVID-19 is presently available, even a small reduction in the impact of obesity on mortality and morbidity from the viral illness might have profound consequences for public health.
It is therefore essential for the health of overweight or obese people to have support in losing weight.