The study by the CoVida Network, a partnership between the Center for Integration of Data and Knowledge for Health at the Oswaldo Cruz da Bahia Foundation (Cidacs/Fiocruz Bahia) and the Federal University of Bahia (UFBA), concluded that people with obesity are more likely to develop an advanced stage of Covid-19 if infected. This is the first scientific production with data used in Brazil to link Covid-19 and obesity and corroborates other research carried out abroad.
When compared to other comorbidities, such as diabetes or cardiovascular problems, being overweight figures as a higher risk of death for adults and the elderly. The condition was responsible for 1.33 times more deaths and 1.31 times more admissions of adults to Intensive Care Units (ICUs).
Similar researches have already been carried out in other countries, such as the United States, China, France, Italy and Mexico. According to Nathaniel de Jesus Silva, one of the authors of the study, obesity was already being identified as a major risk factor for the more serious consequences of Covid-19 by foreign scientists.
“Nevertheless, the evidence was still unclear about the combined effect that obesity and other cardiometabolic diseases such as diabetes and cardiovascular disease play on the severity of Covid-19. In particular, in different age groups”, he explains. “As is known, it is very common for obesity to be associated with a series of other health problems, especially diabetes and cardiovascular disease. Our analysis assesses how the combination of these three diseases can contribute to the evolution of patients”, he added.
In addition to being responsible, alone, for 1.33 times more deaths and 1.31 times more admissions of adults to Intensive Care Units (ICUs), overweight also led 2.69 times more Brazilian adults and elderly to need of mechanical ventilation. In the elderly, the numbers are even more worrying. Obese people over 60 were 1.40 times more admitted to ICU beds and died 1.67 times more than non-obese people.
The group evaluated data from more than 8,848 adults and 12,945 elderly people in the Influenza Surveillance Information System (Sivep-Influenza). There, cases and deaths of Severe Acute Respiratory Syndrome (SRAG) and Covid-19 are registered. The information is provided by the Ministry of Health and was captured by the Integrated Data Platform About Covid-19 (PDI-COVID-19) of the CoVida Network.
In cases where, in addition to obesity, the patients were also diabetic or had a cardiovascular disease, the number of ICU admissions was 1.6 times higher. The number of deaths was 1.79 times higher.
The researchers explain that some factors may explain the relationship between obesity and worsening conditions in patients infected with the coronavirus. Excess weight can cause, for example, glycemic decompensation and reduce the elasticity of the chest. This damage makes the breathing process difficult. More than that, the disease is associated with sleep apnea and obstructive pulmonary disease. All this prevents the proper functioning of the ventilation mechanisms.
The impairment of the immune response is also one of the causes that justify the link between the two diseases. Scientists claim that the overweight individual becomes more vulnerable to infections. Also, his body produces fewer responses to antiviral medications.
“With this evidence, it is expected that all obese people, regardless of severity, age, and existence of other comorbidities, will be included in the priority group for vaccine against SARS-CoV-2. Even patients with lower levels of obesity have already shown strong links with Covid’s serious condition”, highlights Nathaniel. Currently, the National Immunization Plan (PNI) provides as a priority group only Brazilians with grade III or morbid obesity. Thus, only those who have a BMI equal to or greater than 40 fit this priority.