The systematic review and meta-analysis of the applicable knowledge of clinical literature focuses on nine clinical studies, which in total reported the evolution of 6,577 patients with COVID-19 in five countries. The authors conclude that obesity is itself a factor that promotes immediate progression to a serious disease that requires extensive care and particularly increases the death threat. The assignment of studies related to the support of the Sao Paulo Research Foundation – FAPESP.
“Several points contribute to the progression of a serious disease in the context of obesity. One is the limited ability to produce interferons [an elegance of proteins secreted through defense cells and essential for inhibiting viral replication] and antibodies. , adipose tissue functions as a reservoir of the virus, keeping it in the framework longer,” said Silvia Sales-Peres, professor at the University of Sao Paulo (USP) in Bauru and principal investigator of the project.
This potentially high viral load, he said, is not the only challenge patients with a higher body mass index (BMI) face. Recent studies show that chronic low-grade inflammation typical of obesity, caused by the superior expansion of fat cells, makes inflammatory cytokine typhoon triggered through SARS-CoV-2 even more harmful to the lungs.
“Obese patients sometimes have trouble breathing because abdominal adipose tissue compresses the diaphragm and prevents it from moving normally,” Sales-Peres said. “In short, concomitant points make these patients more vulnerable to dependence on mechanical ventilation and other types of care if they contract COVID-19. In the studies we analyzed, 9. 4% of obese patients treated in extensive care sets died. “
Risk scale
BMI is a measure of body fats proportional to the height and weight that is applied to adult men and women and is popular abroad for diagnosing malnutrition and obesity. It is calculated by dividing the weight into kilograms by the length into square meters. BMI of 25 or more, while 30 or more indicates obesity. About 60% of Brazilians are obese and about 20% are obese, according to the Ministry of Health’s telephone surveillance survey on chronic disease threat points (Vigitel).
“A high degree of sensitivity to the new coronavirus when a user reaches a safe number on the BMI scale is not an accident. Impaired antibody production and chronic inflammation herald coVID-19 progression in obese subjects,” Sales-Peres said. Our research also showed that the obesity-related threat is even greater for smokers or subjects with comorities such as diabetes, high blood pressure and lung disease. “
He went on to say that studies like this are vital to alert patients to a desire to protect themselves from the virus and to help the physical condition prepare for the possible call for extensive care.
“We started the test in April, when it wasn’t so transparent that obesity was considered a major threat to COVID-19,” he said.
For the systematic review, the authors searched first on Medline, Embase, Web of Science, BVS/Lilacs, SciELO, Scopus and Google Scholar to choose studies published on April 27 or before key terms such as obesity and COVID-19. they ended up with 8 that met the inclusion criteria and were considered worthy of a meta-analysis because they contained clinical evidence at the highest point for the consultant’s clinical practice.
“The 2018 Vigitel survey showed a 30% increase in the overall prevalence of obesity in Brazil compared to 2006. Considering only the 18 to 24 year old group, the increase of 55. 7%. This makes it incredibly questionable about the threat of severe COVID. -19 related to significant obesity,” Sales-Peres said.