COVID-19 a bad time to be ‘fluffy’
NEXT MONTH will make it two years since COVID19 was first reported to the World Health Organization (WHO). Unfortunately, we are still being plagued by SARSCoV-2, the virus that causes the infection, as surges continue to occur. Widespread vaccination and public-health measures have helped to reduce morbidity and mortality, but people are still becoming very ill and dying from the infection. So it has become painfully obvious that surviving this pandemic will involve more than being stuck with a needle and avoiding other humans.
Data show that a significant proportion of people ending up in intensive care units (ICUs) are not just unvaccinated, but also older or have certain comorbidities. When we hear the term ‘comorbidities’, we associate it with illnesses known to increase the risk of severe illness and death from COVID-19. Diabetes mellitus, hypertension and other types of cardiovascular disease, and autoimmune conditions come to mind. But there is another comorbidity that is deserving of urgent attention: being overweight or obese.
In these situations, there is excessive fat accumulation in the body that poses a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30, obese. The BMI is a value derived from your mass (weight) and height. It is defined as the body mass, measured in kilogrammes (kg) divided by the square of the height, measured in metres (m), and is expressed as units of kg/m2. The risk of severe COVID-19 illness increases sharply with elevated BMI.
Unfortunately, many people who are overweight do not even realise they are, and many who know are unaware of the associated health risks. The potential health issues are many and include hypertension and other cardiovascular disorders such as coronary heart disease and stroke, and type 2 diabetes mellitus. There is also an increased risk of having elevated ‘bad’ cholesterol (LDL) and triglycerides and low ‘good’ cholesterol (LDL), a situation known as ‘dyslipidaemia’, which increases the risks of heart attacks and strokes.
Having excess body fat is also associated with osteoarthritis (a breakdown of cartilage and bone in joints), gallbladder disease, sleep apnoea and breathing problems, and mental disorders such as depression and anxiety. Being above your ideal weight has also been associated with an increased risk of developing over a dozen malignancies, including cancers of the breast, endometrium (lining of the uterine cavity), ovary, colon, liver, gallbladder, and pancreas.
RISK FACTOR
Now added to the list is the increased risk of severe illness, ICU admission and death from COVID19. It has been established from several studies that excess body fat is a risk factor for severe COVID-19 disease and death.
For example, in a recently published meta-analysis ( an examination of data from several studies on the same subject) in Obesity Reviews, researchers pooled data from peer-reviewed papers involving 399,000 patients. They found that obese people who contracted SARS-CoV-2 were 113 per cent more likely than people of healthy weight to be hospitalised, 74 per cent more likely to be admitted to an ICU, and 48 per cent more likely to die.
And younger people are not immune. Researchers at Johns Hopkins University in the United States examined 265 young patients hospitalised with COVID-19 to see if they were more likely to be living with overweight and obesity. They indeed found a correlation, which they hypothesise may be due to physiologic changes from obesity.
These changes include impaired immunity, chronic inflammation, and an increased tendency of blood to clot, all of which contribute to morbidity from COVID-19. Obesity also decreases lung capacity and reserve, compromising breathing, and can make ventilation more difficult should that intervention become necessary. Also, the fact that people with obesity are more likely than people within their appropriate weight range to have other diseases that are independent risk factors for severe COVID-19, including heart disease, lung disease, diabetes mellitus, and metabolic syndrome (a condition in which blood sugar levels, fat levels, or both are unhealthy and blood pressure may be high), increases their risk even further.
The increased risk factor of excess body fat cannot be overemphasised. The pandemic should act as a call for us to pay attention to our overall health and lifestyles, including our diets and levels of physical activity. Our consumption of sugar and junk food should be minimised as we focus on consuming a healthy diet. In addition, the addition of exercise to our lifestyles is definitely of benefit. Indeed, a large study published earlier this year in the British Journal of
Sports Medicine found physical inactivity to be associated with a higher risk for severe COVID-19 outcomes.
So, being ‘fluffy’, as we Jamaicans call the state of having excess body fat, must be recognised as a significant risk factor for poor COVID-19 outcomes during the management of the pandemic and measures taken to educate our populace about it.