COVID-19 and obesity: “awareness” is needed | Coronavirus


Does the British study confirm what we already knew?

[La COVID-19] is a virus that strikes everyone, but does not have catastrophic effects on everyone. Some of the predisposing diseases, which make a person more vulnerable to a viral attack, are hypertension, cardiovascular disease, type 2 diabetes and obesity. But the data published in Italy, France and England are very clear on people under the age of 60: if you are obese and you are under 60, you are twice as likely to be hospitalized, you are twice as likely to get pneumonia and, above all, you are seven times more likely to be hospitalized in intensive care, to be intubated and put on a ventilator.

In France, emergency physicians have observed that obese people represent only 17% of the population, yet they constitute 83% of patients hospitalized in intensive care. It’s huge: five times more than what we should statistically observe!

So obesity is an aggravating factor …

Yes, in the United States, Quebec and Canada, 90% of the deaths we have had were in the elderly and it was more or less the same everywhere on the planet. But it’s not just being old that causes vulnerability to COVID, it’s also having an illness that predisposes you to having it. In our country, 26% of the Canadian population is obese and 37% are overweight.

What is the link between obesity and COVID-19?

It is a complex connection. The accumulation of fat in the abdominal cavity decreases the ability of the lungs to exchange gases. Obese people have reduced lung capacity, the movement of the diaphragm is reduced. So there is a mechanical aspect between obesity and COVID, as is the case with other types of viruses like the flu.

The second link is biochemical. When you are overweight, you have chronic inflammation of the fatty tissue and that is a major problem. People die of COVID from the inflammatory storm and the body’s inability to respond to it. When you are obese, you already have a pre-inflammatory condition that the virus exacerbates.

A coronavirus S protein (in pink) binds to an ACE2 receptor in a human cell (in blue), which ultimately allows it to enter the cell.

Photo : iStock / selvanegra

What is the role of angiotensin II converting enzyme?

This is the third link between obesity and COVID-19. In obese people, the capillary network of blood vessels necessary to supply this fat with oxygen and nutrients is greater. If you are 10 pounds or 20 pounds too much, you have thousands of miles more blood capillaries and therefore more gateways for the virus. The receptor that allows the virus to enter your cells is called the angiotensin converting enzyme. It is overexpressed in the blood vessels and therefore the virus penetrates better and causes the cardiovascular problems associated with COVID-19.

But it’s still taboo to stigmatize overweight people, right?

We must realize that obesity is a health problem. The World Health Organization said it last year: obesity will be at 21e century what tobacco was in the 20e century.

Obesity is linked to the development of several chronic diseases and a vulnerability to viral attacks, so be aware that there is no obesity health. We must get out of the political correctness that prevents us from speaking freely about obesity. Here, we hide it under the carpet as if it was a public disgrace. We have to take charge individually and do it for the whole of society. It is a global awareness that we must do.

This text was adapted from an RDI morning weekend interview in order to make it easier to read.

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