The obesity is a disease that increases the risk of hospitalization, admission to the ICU, the need for mechanical ventilation and mortality in patients with Covid-19, compared to those who have a normal weight. This has been detailed by specialists from the Spanish Society for the Study of Obesity (Seedo) and the Spanish Society of Endocrinology and Nutrition (SEEN) during a press conference in which they have asked that, after the elderly and health workers, the people with obesity are considered a priority in the strategy of vaccination against coronavirus.
«With a Body Mass Index (BMI) above 40, in those under 50 years of age, a very important relationship between obesity and a worse evolution of Covid-19. These patients present between 3 and 15 times more complications compared to a population of the same age without obesity, “explains Dr. Javier Escalada, president of SEEN. They also have a thromboembolism rate between two and three times higher than patients without excess weight and a higher risk of acute renal failure during hospitalization. “It has been clearly demonstrated that obesity in its most severe grades, 2 and 3, is an independent risk factor for a worse evolution and higher mortality from Covid”, concludes Dr. Escalada.
Specifically, people with excess weight have a 46% higher risk of contracting coronavirus, a 113% higher risk of hospitalization due to Covid-19, a 78% higher risk of admission to the ICU compared to the population with normal weight, and the risk of mortality is 48% higher.
An argument they consider important enough to suggest that “those people with a BMI over 35 They should be prioritized in vaccination against Covid-19, “said Dr. Albert Lecube, vice president of Seedo and head of the Endocrinology and Nutrition Service of the Arnau de Vilanova University Hospital (Lleida). This specialist has also asked that the message of social distance, mask and hand hygiene to prevent Covid be added “the need to maintain a healthy weight».
Higher risk also in young people
Experts have highlighted that, globally, severe obesity increases the risk of mortality from Covid-10 by almost 50%, but where it has the greatest impact is on young people. In patients under 50 years of age, with a BMI above 40 (obesity grade 3), mortality was 8%, while with obesity grade one (BMI between 30 and 35), mortality was 3%. that is, almost three times less.
People who are overweight have a increased risk of contagion, greater number of coronavirus receptors and worse clinical evolution of Covid for several reasons: “In obesity there is a constant state of inflammation, which is further enhanced by Covid”, points out Dr. Ana de Holanda, coordinator of the working group of Seen obesity. Along the same lines, the expert has pointed out that the immune response in people with obesity is poor and that makes them unable to defend themselves properly against infections. In addition, he explained that adipose tissue is a reservoir for viruses. They also have more mechanical and respiratory problems because they have less space for the lungs to expand. And during treatment, it is more difficult to intubate and turn an obese patient face down.
Obesity is also behind most of the metabolic problems such as diabetes, hypertension, and dyslipidemia, which in turn are risk factors for severe Covid. “The obesity it is a disease not a condition that passes. 22% of the Spanish adult population is obese, and 18% of the infant and adolescent ”, warns Dr. Susana Monereo, secretary of Seedo.
Worst approach to being overweight
In addition, confinement has worsened the approach to excess weight. 98% of professionals who treat patients with obesity and who have been surveyed by Seedo and Seen, believe that the pandemic and confinement have had a negative impact on obesity and its complications.
Dr. Susana Monereo says that “only 2.4% of health professionals dedicated to obesity think that obese patients have been able to maintain the treatment they had prescribed (diet, exercise and / or drugs).” In addition, only 12% of the professionals surveyed recognize that they have been able to conserve pbariatric surgery programs in their hospitals.
During the first two months of home confinement, it was confirmed that 49.8% of Spaniards had gained weight, the majority (86.6%) between 1 and 3 kilos. The combination of higher intake with less physical activity has taken its toll, but “the most serious thing is that 40.3% of those surveyed who gained weight did not take any measures to manage this situation,” says Dr. Diego Bellido, chief of the Endocrinology and Nutrition Service of the Ferrol University Hospital Complex, who also highlights another risk factor in weight gain: “Among the people who responded to the survey, those who lived in southern Spain gained more weight.”
“Despite being a growing health problem, which has a very negative impact on morbidity and mortality and, even greater among people affected by Covid-19, attention to people with obesity is being relegated,” says Dr. Lecube .