Obesity-Related Conditions in Men Seem to Worsen the Effect of COVID-19 According to CDC

by April 13, 2020

Obesity-related conditions seem to worsen the effect of COVID-19; indeed, the Centers for Disease Control and Prevention (CDC) reported that people with heart disease and diabetes are at higher risk of COVID-19 complications. This global pandemic is also quickly becoming a global economic crisis, which will disproportionately affect the world’s most vulnerable population. In many countries this same segment of the population is also the one at higher risk of obesity, which might worsen the obesity crisis in the future.

In the emergency rooms of virus hotspots around the world, medical staff are seeing a greater number of men than women suffering severe symptoms of COVID-19, with obesity emerging as another potentially aggravating factor. But experts are still unsure why.

What first began to appear as a pattern in China, where the virus emerged at the end of last year, has echoed through hospitals in Europe and the United States as the pandemic spreads.

“More men than women have serious problems, and patients who are overweight or have previous health problems are at higher risk,” said Derek Hill, Professor of Medical Imaging Science at University College London.  – Paris (AFP)

Given the extremely high rates of obesity around the globe we expect that a high percentage of the population who will contract coronavirus will also have a BMI over 25. Furthermore, persons with obesity who become ill and require intensive care present challenges in patient management as 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 by nursing staff and, like pregnant patients in ICUs, they may not do well when prone.

Special beds and positioning/transport equipment are available in specialized surgery units, but may not be widely available elsewhere in hospitals and certainly not in all countries. In general health systems are already not well set up to manage patients with obesity (as reported by our MAPPS study published in Clinical Obesity) and the current crisis will expose their limitations even more.

Early statistics from Britain’s independent Intensive Care National Audit and Research Centre on people treated in intensive care for the virus confirm this phenomenon: 73 percent are men and 73.4 percent are classed as overweight.

According to preliminary data of outcomes for those patients who had either recovered or died of COVID-19 in the period before April 3, obese patients were also less likely to recover after receiving critical care.

Some 42.4 percent of people with a body mass index (BMI) over 30 were able to go home after successful treatment, compared with 56.4 percent of patients with a BMI of less than 25.

French emergency rooms have seen “a very large proportion of overweight or obese patients,” ICU doctor Matthieu Schmidt at the Pitie-Salpetriere hospital in Paris told broadcaster France 2, adding that “three quarters” of all patients were men.

In New York there is a similar picture emerging.

“I’m in the emergency room, and it’s remarkable — I’d estimate that 80 percent of the patients being brought in are men,” Hani Sbitany, a reconstructive surgeon at Mount Sinai Health System who has been treating COVID-19 patients in Brooklyn.

“It’s four out of five patients,” he told the New York Times.

But why are so many men affected? Just months after the new coronavirus appeared, experts say it is too early to tell for certain.

The high incidence of men presenting with more severe symptoms is for now “an observation”, said Jean-Francois Delfraissy, who leads the coronavirus science council advising the French government.

While he said there was “no clear explanation”, he raised the theory that men had a higher frequency of multiple pathologies.

“I am very humble vis-a-vis this virus. I did not know it three and a half months ago. There are lots of question marks,” he told France Info radio.

COVID-19 & Obesity

In addition to that, the current pandemic might contribute to an increase in obesity rates as weight loss programs (which are often delivered in groups) and interventions such as surgery are being severely curtailed at present – and this is likely to go on for a long period of time. The measures introduced in some countries (e.g. not leaving the home for several weeks even for those who are not sick) will have an impact on mobility and enforced physical inactivity even for short periods of time increases the risk of metabolic disease.

Finally, the current crisis and the need for self-isolation is prompting many to rely on processed food with longer shelf life (instead of fresh produce) and canned food (with higher quantities of sodium) and we might see an increase in weight if this persists for a longer period of time.

World Obesity Federation will release regular information on its website regarding any new discovered associations between COVID-19 and obesity and its comorbidities. We will monitor through our global members specific challenges/ suggestions that might come from different countries on how to respond to the crisis.

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