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Obesity increases the risk of Covid-19 death in men

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Coronavirus was an unpredictable enemy from the beginning. It causes infections that are silent or almost imperceptible in some people and a series of complications that overwhelm the body and cause death in others.

Why some patients get over their illness and others fall down is a matter that has plagued doctors.

Older and chronic health conditions such as high blood pressure and heart disease are known to increase the risk of severe Covid-19. The Center for Disease Control and Prevention also lists extreme obesity as a high risk.

But is it because of excess weight in itself? Or what are all the health problems with obesity, such as metabolic and respiratory problems?

New research points out obesity itself as the culprit. Ah Analysis of thousands of patients treated by the Southern California health system identified extreme obesity As an independent risk factor for dying among Covid-19 patients-most surprisingly among young and middle-aged adults under age 60, especially among men.

Among sick women, the body mass index (a measure of body fat based on height and weight) does not appear to be independently associated with an increased risk of death regardless of age, the authors say. ing. Men who tend to have more visceral and abdominal fat. The study was published Wednesday in an internal medicine annual report.

“The Body Mass Index is a really important and independent risk factor for death for people diagnosed with Covid-19,” said Sara Tartof, the lead author of the study, a researcher at Kaiser Permanente in Southern California. States.

But “the impact is not uniform across the population,” she added. “You didn’t really see it in the elderly, and we didn’t consider it a significant risk for women of any age.”

Obesity and coronaviruses are a dangerous combination for several reasons.

Obesity causes respiratory limitation, making pneumonia and other respiratory infections more difficult to remove. Fat is biologically active and a source of proinflammatory chemicals that promote a chronic inflammatory condition in the body even before Covid-19 begins. Obesity causes metabolic changes and abnormalities without diabetes.

This study is not the first to discover obesity as the criminal of Covid-19 death in adolescents. Earlier reports from China and Italy did not focus on obesity as an independent risk factor, but doctors in other parts of the world where obesity is more prevalent have been shown to Have often found to be obese.

Only 6% of the Chinese population is obese, 20% in Italy and 24% in Spain. In contrast, the United States has one of the highest obesity rates in the world.

About 42% of American adults have a body mass index of 30 or higher, Classify them as obesity, And 9% have a BMI of 40 or more. (According to federal guidelines, a person who is 5’9” tall and weighs 270 pounds or more has a BMI of 40.) A 304 pound person has a BMI of 45.

A normal weight range is a BMI of 18.5 to 24.9. People with a BMI of 25-29.9 are considered overweight.

Ah The report released by the British Public Health Service Overweight and obesity increased the risk of complications and death from Covid-19. There are hundreds of similar articles published on this topic.

In it A study conducted last month at Columbia University, also published in the Annals of Internal Medicine, shows that Covid-19 individuals who are very obese 60% more likely to require mechanical ventilation or die from Covid-19. The study says that this also applies to people under the age of 65.

“Are there more and more obese people in the United States, so are we looking at this?” said Dr. David Cass, professor of medicine at Johns Hopkins University. The person who wrote the editorial accompanying a new study.

“But this is more than a percentage of the general public,” he said. “Not only are there many people who are fat, but there are also many people who are very sick.”

Dr. Kass wrote in a lancet in April, pointing out that many young Covid-19 patients admitted to American hospitals are suffering from obesity, as coronaviruses spread to areas where obesity is widespread. Predicted to affect younger people.

He said different fat distributions could also help to understand the different effects of obesity on men. “When you look at men and women side-by-side with the same BMI, men are much more likely to have background problems that we consider to be a factor that puts us at greater risk.

To conduct the new study, researchers conducted mid-February to May 2 of 6,916 Kaiser Permanente Southern California Health Systems treated with Covid-19 as both inpatients and outpatients. We analyzed the health records of the members.

The median age of the patients was 49 years and the average BMI of the patients was 30.6. Almost half were obese.

In general, Obesity rates vary by race and ethnicity, According to the CDC, the age-adjusted obesity rate for blacks is 49.6%, 45% for Hispanics, 42% for Whites, and 17% for Asian Americans.

More than half of Kaiser Permanente patients were Hispanic, about 1,000 were Asian/Asian American, and 584 were black. Many patients had potential health problems linked to poor Covid-19 results. Approximately 206, or 3%, of patients died within 21 days of receiving a Covid-19 diagnosis.

To find out if obesity itself is associated with a higher risk of death, researchers are investigating conditions known to be associated with more severe forms of Covid-19, such as hypertension and diabetes. Tried to exclude. As a heart, kidney, chronic lung disease.

Scientists also wanted to know if demographic factors such as age, gender, race and ethnicity would play a role.

Black and Latino populations have been unfairly attacked by the virus and have high hospitalization and mortality rates, but studies did not find race or ethnicity as an independent risk factor.

Researchers have found that extreme obesity is an independent risk factor for worse outcomes. “We are not saying there is no gap, we are cutting away what is causing the gap,” Dr. Tartov said.

“We see that racial and ethnic minorities have worse consequences. They are also likely to be obese or have poor access to health care, and are likely to have comorbidities.” is.”

Among the Covid-19 patients in this study, those with extreme obesity, whose BMI was defined as 40 or higher, had a nearly three-fold higher risk of death than their normal weight. According to Tartov, people with a BMI of 45 had more than four times more mortality than normal weight patients, and the risk was most pronounced in men and people under the age of 60.

The study highlighted the intersection of two major health concerns, and Dr. Tartov highlighted the need for policy to address both.

“There are many things we can do to improve our fight against Covid. There are many things we can do to improve our strategy against obesity,” she said. “It’s also fashionable and something we need to pay attention to.”

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