Unlike the first wave of Covid-19 when most people requiring hospitalization were the elderly and people with comorbidities, this time younger people — those younger than 40 years old — are developing severe symptoms that necessitate hospital stay. While one explanation for this is the increased virulence of the coronavirus in circulation, doctors say obesity might also be playing a big role in this.
According to Dr Suresh Kumar, medical director, Lok Nayak Hospital, most of the younger Covid-positive people requiring admission in his hospital were either overweight or obese. “Two patients aged 40 and 41 years died in our hospital on Thursday. One of them weighed 120 kg, the other around 90 kg,” Kumar revealed, while explaining that obese people have high insulin resistance and their lung function and respiratory reserve are also compromised, thus predisposing them to disease-related complications.
Dr Sumit Ray, critical care expert, added that overweight people had a dysregulated immune response. “Also, the mechanical function of breathing is affected in obese people,” Ray said.
A study recently published in The Lancet Diabetes and Endocrinology Journal, based on more than 6.9 million people living in England and including data from more than 20,000 Covid patients who were hospitalized or died last year, also established that the risk of worse outcomes from the disease start increasing in people with a BMI over 23kg/m2, which is considered to be in the healthy range. According to the study, the risk of hospitalization was 5% higher for each one-unit increase in BMI and the risk of ICU admission was 10% higher for each unit increase. “Underweight people (BMI less than 18.5) also experienced poor outcomes from Covid,” the authors noted.
Besides modest excess weight being associated with greater risks of severe complications, the study showed excess weight leading to severe risks was greatest in the 20-39 age group and decreased after age 60. Lead author Dr Carmen Piernas of University of Oxford’s Nuffield Department of Primary Care Health Sciences said, “We also found that the risks associated with excess weight are greatest in people aged under 40 years, while weight has little to no effect on your chances of developing severe Covid-19 after age 80. These findings suggest that vaccination policies should prioritise people with obesity, especially now the vaccine is being rolled out to younger age-groups.”