Editor’s Note: Find the latest COVID-19 news and guidance from Medscape Coronavirus Resource Center..
New studies suggest that the majority of COVID-19 hospitalizations in the United States are due to four existing cardiac metabolic states.
The authors estimate that 30% of the total 906,849 COVID-19 hospitalizations that occurred in adults in the United States as of November 2020 were the cause. obesityFrom 26% High blood pressureFrom 21% of diabetes; and 12% heart failure..
From the data, researchers estimate that nearly two-thirds (63.5%) of hospitalizations are due to these cardiovascular metabolic states, and in the absence of these states these hospitalizations were preventable. I will.
They estimate that a 10% reduction in these four cardiac metabolic states could have prevented 11.1% of hospitalizations with COVID-19.
The authors need to do more to promote healthy lifestyle measures to improve overall cardiometabolic health and minimize the risk of severe COVID-19. I think there is.
Dr. Darish Mosafarian
“It’s a sad fact that the disease has been going on for a year, killing millions and hospitalizing tens of millions around the world, and the main way to prevent such serious consequences. I’m not working on one of them, “said senior author Dariush Mozaffarian, MD. Medscape Medical News..
“We’re closing our business and stopping people from seeing loved ones, but we’re not telling them to lose weight and exercise. Diabetes and obesity are a way to reduce severe COVID disease. We need to focus our public health message on reducing obesity, “he said.
Gerald J. and Dorothy R. Friedman, Cardiologist and Dean of the Faculty of Nutrition Science Policy, Tufts University, Boston, Massachusetts, added: Diabetes and high blood pressure improve in just a few weeks. You should shout this from the roof with a message asking you to wash your hands, social distance, and wear a mask. “
Research Published online February 25 Journal of the American Heart Association.
For their study, researchers used mathematical simulations to prevent the number of COVID-19 hospitalizations nationwide that Americans would have been able to prevent if they had not suffered from four major cardiac metabolic states. And estimated the proportion.
Researchers used data on the association between COVID-19 admissions and each of the four conditions from a study of hospitalization-related factors in 5279 COVID-19 patients at major health centers in New York City. did.
Data from the Centers for Disease Control and Prevention’s COVID-NET system and COVID tracking projects were used to estimate COVID-19 admissions by population subgroup. Data on the national distribution of the four conditions are from the latest National Health and Nutrition Examination Survey.
The model showed that age and race / ethnicity were associated with COVID-19 hospitalization disparities as a result of these four conditions. For example, it was estimated that about 8% of COVID-19 hospitalizations for adults under the age of 50 were due to diabetes, compared to about 29% for COVID-19 hospitalizations over the age of 65. Obesity had an equally detrimental effect on COVID-19 hospitalization across age groups.
At all ages, COVID-19 hospitalizations due to all four conditions were higher in blacks than in whites and generally higher in Hispanics than in whites for diabetes and obesity.
For example, in people over the age of 65, diabetes was estimated to cause about 25% of white COVID-19 hospitalizations, about 32% of blacks, and about 34% of Hispanics.
When the four conditions were considered together, the rate of causative hospitalization was highest among black adults of all ages, followed by Hispanics. For example, in adults aged 18-49 years, the four conditions were estimated to combine to cause about 39% of white COVID-19 hospitalizations and 50% of blacks.
“National data show that blacks and Hispanic Americans suffer from the worst consequences of COVID-19. Our findings show that people with cardiometabolic status are particularly affected. We support the need to prioritize vaccine distribution, good nutrition, and other precautions among the receiving groups. Health inequalities. “
“Policies aimed at reducing the prevalence of these four cardiac metabolic states between blacks and Hispanic Americans are state or national policies aimed at reducing health inequalities from COVID-19. It must be part of the debate, “he said.
Mozaffarian pointed out that the study used an established analytical modeling approach, but the results were estimates and did not prove the cause and effect.
“Relevance is not equal to causality, and our modeling approach does not demonstrate that improving cardiac metabolic health reduces the risk of COVID-19 hospitalization, but our simulated findings. The size of the supports the need for interventional studies to test this possibility, “says the researchers.
Still, Mosafarian believes that the consequences reflect the cause and consequences.
“These conditions are very strongly associated with severe COVID infection. We have adjusted for age, gender, and other medical conditions, but these four cardiovascular metabolic states are independently associated with COVID hospitalization. I see, “he said. “It’s not just a respiratory virus. It causes widespread vasculitis and is consistent with these cardiac metabolic states. Without these conditions, COVID is less serious,” he commented.
“But even if the 64% estimate is off by half (I don’t think so), it will be one-third of the severe cases caused by four preventable cardiometabolic disorders. It’s a huge number. “
COVID-19 is a fast pandemic in addition to a slow pandemic of obesity and diabetes.
Mosafarian emphasized that the public needs to understand the importance of good nutrition. “This is the foundation of health. Malnutrition is the number one cause of illness worldwide and contributes to the COVID situation,” he said. “COVID-19 is a fast pandemic in addition to a slow pandemic of obesity and diabetes.”
Comments on the study of Medscape Medical News, George L. Bacris, MD, Doctor of Medicine, University of Chicago School of Medicine, Director of the American Heart Association General Hypertension Center in Chicago, Illinois, said the data are consistent with observations of older people, especially those with diabetes and heart disease As mentioned, and lung disease, there is an increased risk of more serious disease symptoms of COVID-19.
However, based on many epidemiological sub-studies, he pointed out that hypertension in the absence of heart disease, lung disease, or diabetes is not the only factor in the severity of COVID.
“The government has previously campaigned to encourage exercise and weight loss, but all the programs available to promote this have not helped. The concept of cognitive dissonance is applicable. People are at risk. I’m aware, but it’s very difficult to change behavior. ”Bakris was added.
Mosafarian acknowledges the difficulty of persuading people to change their habits and points out that the COVID pandemic was an exceptional event that caused the majority of people to change their behavior.
“People will also change their diet and exercise habits if given a clear message that they can reduce the risk of serious COVID consequences,” he said.
He urges key stakeholders (government, cardiovascular societies, and businesses) to convey the message.
“Every day, we need to get advice on increasing vegetables, reducing chips, soda, processed foods, and walking a little longer,” he said. “This can have a significant impact on the outcome of COVID disease and overall public health.”
This study was supported by the National Institutes of Health and the National Institute of Cardiopulmonary Blood. Mosafarian receives research funding from the Gates Foundation and The Rockefeller Foundation. From Global Organization for EPA & DHA Omega-3 (GOED), Barilla, Banji, Indigo Agriculture, Motif Foodworks, Amarin, Cleveland Clinic Foundation, America’s Test Kitchen (Medium), Akasti Pharma and Danone (Important) Personal charges. He joined the Scientific Advisory Board of emerging companies focused on health innovation, including Brightseed, Calibrate, DayTwo, Elysium Health, Filmicine, Foodome, HumanCo, Tiny Organics (important), and chaptered from UpToDate. I have received the usage fee. Everything except the submitted work.
J Am Heart Assoc. Published online on February 25, 2021. Full text
Learn more about heart.org | Follow Medscape Cardiology twitter And Facebook..
