NEW DELHI: Obesity, a condition that often coexists with diabetes and hypertension, is emerging as a risk factor for severe Covid-19 infection even in those below 60 years. In this light, doctors have recommended to the WHO and the ICMR that it include information on weight and height of patients to enable estimation of body mass index (BMI) and assessment of obesity in the current case record forms.
The risk was highlighted in a paper in the journal Current Science. Recently, doctors in the UK’s NHS had issued a public health warning after it was found that the majority who were severely ill were overweight or obese. It was reported that out of 2,204 Covid-19 patients admitted to 286 NHS intensive care units, 73% were overweight or obese. A very high proportion of those requiring mechanical ventilation in a study in France were also obese, and the risk increases with increasing obesity.
A study which analysed data for more than 4,000 Covid-19 patients who sought care in a hospital in New York identified obesity as a prominent risk factor. One of the authors of the paper, Dr Anurag Bhargava, Professor of Medicine and Head Centre for Nutrition Studies at Yenepoya (Deemed University), Mangalore, pointed out that obesity, a risk factor for mortality in the Covid-19 pandemic, was also one in the H1N1 pandemic.
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“Obesity, general and/or abdominal is associated with higher levels of inflammatory markers in the body even before the virus strikes. The virus markedly accelerates the inflammatory process,” said Dr Srinath Reddy of the Public Health Foundation of India. Dr Reddy explained that abdominal obesity is more common than general obesity in Indians and that it is also a better predictor of cardiometabolic risk than general obesity.
The paper also states that obesity could predispose to more severe Covid-19, as higher levels of proteins favor inflammation in the obese. One of the mechanisms for severe Covid-19 are high levels of these proteins, which are called cytokines.
Dr Reddy explained that both forms of obesity also reduced the lungs’ capacity to expand, causing mechanical limitation. With the coronavirus targeting the lungs, this could tilt the balance towards a poor outcome.
“It would be prudent for obese individuals (Body mass index greater than 30 kg/m2) to observe hand hygiene, adopt masking in crowded places, and social distancing more meticulously,” said Dr Bhargava.
