COVID-19 and Obesity
Obesity and obesity-related conditions also seem to worsen the effect of COVID-19. In particular, the Centers for Disease Control and Prevention (CDC) says that people with heart disease and diabetes are at higher risk of COVID-19 complications.
A high percentage of those infected with the coronavirus are obese, and this puts a special strain on the health system. Persons with obesity who require intensive care present multiple challenges in patient management. It is more difficult to intubate patients with obesity, it can be more challenging to obtain diagnostic imaging (as there are weight limits on imaging machines), patients are more difficult to position and transport and, like pregnant patients in ICUs, they may not do well when prone.
Johns Hopkins cardiologist David Kass recently co-led a study that links higher body mass index to more severe cases of COVID-19 and points to obesity as a common condition among younger patients in particular.
What factors might explain why obese patients with COVID-19 are more likely to be hospitalized?
Obesity makes breathing difficult as it puts extra pressure on the diaphragm. When patients contract COVID-19, the membranes separating their lung airway sacs become leaky, allowing fluid to enter their airways. This makes it hard to get oxygen from the air to the blood, so the diaphragm has to work even harder.
Inflammation is another factor. Fat itself is metabolically active, and it produces a fair number of pro-inflammatory molecules called cytokines, which are a type of immune protein. It is as if your body is kind of battling itself continuously—a little war caused by signals released from fat cells which the immune system responds to, producing a low level of background inflammation. Superimpose a bigger battle with a novel virus that the immune system has not seen before, and your immune system becomes hyper-activated. As with the seasonal flu, many of the symptoms patients can suffer when infected with COVID-19 are actually caused by their immune system’s response.
Another factor is the ACE2 protein in fat cells. This protein is key for the COVID-19 virus, since the virus must bind to it in order to gain entry into a cell. It turns out fat cells express ACE2 at fairly high levels, and there is some evidenced that respiratory viruses shed more slowly from fat. This could cause an obese individual to become more infectious even as their COVID-19 symptoms improve.
COVID-19: Tips for prevention
These everyday actions to help prevent the spread of any respiratory virus, including COVID 19:
1. Wash hands often for 20 seconds and encourage others to do the same.
2. Use hand sanitizer with at least 70% alcohol if soap and water are unavailable.
3. Wear a cloth face covering in public and during large gatherings.
4. Cover coughs and sneezes with a tissue, then throw the tissue away.
5. Avoid touching your eyes, nose, and mouth with unwashed hands.
6. Disinfect surfaces, buttons, handles, knobs, and other places touched often.
7. Stay six feet apart from others.
8. Avoid close contact with people who are sick.
9. Avoid crowds.
10. Do not shake hands.