New Delhi: Doctors in India dealing with the Covid-19 outbreak are increasingly noticing that patients have no other medical condition but obesity.
Almost half the Covid-19 patients approaching India’s largest public hospital, the All India Institute of Medical Sciences (AIIMS), are obese.
“Out of every 10 Covid patients I treat, 5 to 6 people suffer from obesity. These are middle-aged adults who suffer from obesity around the waist. We urgently need to understand the connection between obesity and Covid-19,” Dr Rashid Gouri, senior resident at AIIMS, told ThePrint.
“There is no Indian study that links obesity to Covid-19, but it’s common sense to link both,” he said, adding that obesity could lead to more than one ailment that could complicate a Covid-19 infection.
“Excess body fat introduces not just one but multiple health conditions. It impacts the functioning of the heart and lungs at the same time, increases the chances of one being a diabetic, and hence, reduces immunity,” Dr Gouri said.
Dr Navneet Sood, pulmonology consultant at Dharamshila Narayana Superspeciality Hospital in Delhi, also said about 50-60 per cent of Covid-19 patients he sees are obese.
“Obese patients usually suffer from diabetes, heart ailments, reduced lung functioning, and other lifestyle diseases. All these are associated with poor outcomes in Covid-19 patients. This is why we are seeing more hospitalisations and ICU admissions of obese patients,” Dr Sood said.
A 2019 study found that India has more than 135 million individuals affected by obesity, especially among urban populations and states with high socio-economic indicators. However, the prevalence rate of obesity in India is much lower than in the United States and the United Kingdom.
Why obesity is dangerous for Covid-19 patients
Doctors warn that saving these patients from Covid-19 is an uphill task.
“They have restricted lung capacity already. Their chances of survival are sadly very less once they go on ventilators,” said Dr Sushila Kataria, physician at Medanta, Gurugram, who successfully treated a group of Italians suffering from Covid-19 in the early days of the outbreak in India.
According to Dr Animesh Arya, senior consultant for respiratory medicine, allergy and sleep disorders at Delhi’s Sri Balaji Action Medical Institute, “Obese people have a lower level of immunity due to inflammation, driven by certain cells in the fat tissue. They start experiencing breathlessness even after doing minor physical work, as the process of oxygen supply to the various parts of the body is compromised.
“They are at the higher risk of a number of diseases, and COVID 19 is one of them as well. In the present scenario, during lockdown, more-than-normal eating and no physical activity can add to this risk of gaining weight and subsequent consequences,” said Dr Arya.
Dr Kataria from Medanta concurred. “Due to the collection of fat, chest expansion is difficult for obese people, due to which their lung function is compromised. The reduction in lung volume is not supportive of any illness. Also, the fat is collected on their neck area, which makes breathing difficult while sleeping. It puts severe pressure on the right side of the heart as well,” she said.
Dr Gouri from AIIMS added: “Their lipid profile — which measures heart functioning — is abnormal along with the insulin resistance (which causes diabetes). The resistance to infections is compromised.”
Obesity also puts children at increased risk. According to Dr Vivek Bindal, vice-chairman, Institute of Minimal Access, Metabolic and Bariatric Surgery at Sir Ganga Ram Hospital, “Obesity is a cause of concern as it may put the younger population at risk, too. For instance, in Delhi, 30 per cent of school children are overweight and 10 per cent are obese.”
Both Dr Sood and Dr Bindal told ThePrint that India needs a study to establish the link between obesity and contracting coronavirus.
In countries like France, the US and the UK, figures suggest that patients who are overweight are at significantly greater risk, according to a report published by Financial Times.
“In New York City, a study of 4,000 Covid-19 patients found that obesity is the second strongest predictor, after their age, of whether someone over 60 will need critical care,” the report stated.
The US’ Centers for Disease Control and Prevention (CDC) have now included severe obesity as a risk factor for Covid-19 (for a Body Mass Index of 40 or above)
Prof. Jean-François Delfraissy, head of the scientific council advising the French government on the epidemic, said last month: “Being overweight is a major risk for people infected with the new coronavirus… This virus is terrible, it can hit young people, in particular obese young people. Those who are overweight really need to be careful.”
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