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NHS Audit Reveals Two-Thirds of Critical Coronavirus Patients Overweight

Apr 14, 2020
 
Editor: David L. Joffe, BSPharm, CDE, FACA

Author: Mit Suthar, PharmD. Candidate, LECOM School of Pharmacy 

Audit also found 40% of critical coronavirus patients are under the age of 60. 

Sixty-three percent of patients with coronavirus in the Intensive Care Unit in the United Kingdom hospitals are overweight, have obesity, or morbid obesity.  Also, unfortunately, while the average age of patients suffering severe symptoms due to the virus is 64, 37% of patients are under 60 years old. 

These statistics were gathered from The Intensive Care National Audit and Research Centre, which analyzed all admissions to critical care units in the UK up until midnight on March 19th. There were 194 coronavirus patients in the ICU at that time; however that number is considered to have skyrocketed in the last few days. 

The document provides an inside look into the characteristics of these critical coronavirus cases. It uncovered that patients with obesity are at higher risk of severe complications from COVID-19, which is a concern for healthcare professionals as two-thirds of adults in the UK population are categorized as having obesity. 

The revelation that more than a third of critically ill coronavirus patients are under 60 shows that it is not an infection that only the elderly are at risk for, as previously assumed. 

The study found that 71% of all coronavirus patients in the ICU were males, and only 9% of patients (18 patients) had severe comorbidities such as heart conditions or lung disease.  

Patients with obesity are known to have a higher risk of serious complications or death due to infections, such as the flu. The immune systems of overweight people are ramped continuously up as they attempt to repair the damage to cells caused by inflammation. Since the body is already preoccupied with fighting the ever-present inflammation, it has fewer resources to defend itself against the coronavirus infection. It is at higher risk of contracting pneumonia. 

Concurrently, patients with obesity generally eat an unhealthy diet, lacking fruits and vegetables, deficient in fiber and antioxidants, which help keep the immune system healthy. The surplus weight also makes it difficult for the diaphragm and lungs to expand fully, making it difficult for these patients to draw in a much-needed deep breath. This excess weight against the chest limits the amount of oxygen that can reach organs. The organs will thus begin to fail due to being starved of oxygen. ` 

The majority of patients with a Body Mass Index greater than 40 also suffer from breathing problems that range from simple shortness of breath to a potentially life-threatening condition known as obesity hypoventilation syndrome (OHS). This is particularly relevant as COVID-19 kills by spreading deep into the lungs and causing complications such as pneumonia.  The culmination of all these factors explains why the lungs of patients with obesity are more likely to fail quickly when they contract coronavirus compared to healthier patients.  

Patients who are overweight also tend not to participate in physical exercise. Studies have shown that physical activity strengthens the immune system by increasing the numbers of immune cells.  

The poor circulation due to clogged up arteries exacerbates infections because it makes it more difficult for the blood to carry immune cells to reach various parts of the body.  

Patients with obesity are also more likely to suffer from diabetes and heart disease, which are two chronic conditions known to increase the risks associated with coronavirus. 

Unfortunately, patients with diabetes face a higher chance of experiencing severe complications from COVID-19. However, it is essential to note that patients who are well-managed with their diabetes have the same risk of getting seriously sick as the general population. 

Practice Pearls: 

  • Excess weight on the chest makes it difficult for patients to draw in a deep breath and exacerbates pneumonia risk 
  • Weakened immune systems due to inflammation allow COVID-19 to spread to lungs and increases the risk of contracting pneumonia 
  • The culmination of numerous factors associated with obesity makes patients with obesity much more likely to suffer severe complications from Coronavirus 

 

Reference for “NHS Audit Reveals Two-Thirds of Critical Coronavirus Patients Overweight”:
Boyd, Conner. “Coronavirus: Overweight Patients with High BMI More at Risk.” Daily Mail Online, Associated Newspapers, 23 Mar. 2020

 

Mit Suthar, PharmD. Candidate, LECOM School of Pharmacy