Why Are Obese People Fairing Worse In This Pandemic?

[gordiescotland1]

I have been reading that particularly men who are obese are ending up having a really rough time with this, more needing ventilation and worse more obese people dying. Anybody know what the reason for this is. Does being overweight affect your immune system?

[calmck]

I would imagine because they art generally more at risk for health problems and when they get the virus have a harder time deep breathing

[CrapAtCryptics]

I`d say there are probably a number of reasons including the pressure of the extra weight on your lungs / chest and the higher percentage of fat cells in your blood reducing their ability to carry oxygen.

[woofgang]

as I understand it there are mechanical issues with ventilating obese people.

[barry1010]

Obese people's bodies are already under a strain just having to cope with the extra weight and fat around their vital organs. Many obese people suffer from breathing difficulties such as asthma and sleep apnoea. Most are less active and not as fit as they could be. Good explanation in the Daily Mail

Professor Kenny Baillie at Edinburgh University and Professor Calum Semple at Liverpool University, said that it was likely excess fat around the internal organs was adding to the 'cytokine storm' caused by covid-19 - where the body releases too many proteins in an effort to fight off the virus.

Studies have shown obese people are more likely to suffer serious complications or die from infections, such as the flu.

Doctors say the immune systems of fat people are constantly ramped up as they try to protect and repair the damage inflammation causes to cells.

Using all its energy fending off inflammation means the body's defence system has few resources left to defend against a new infection like COVID-19.

[pastafreak]

I've read that it's related to metabolic syndrome, diabetes, and inflammation. Diabetes is connected with a weakened immune system if I'm not mistaken.
This may explain it...

https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/

[Old_Geezer]

It's because we have trouble waddling all the way to the hospital.

[NickorWan]

There are quite a few medical reports online explaining why obese people have poorer lung function. Here is one.

https://acphospitalist.org/archives/2013/09/conference01.htm


There are also a number of reports claiming that ventilators are doing more harm than good. They claim that the lungs need oxygen but not pressure, and that the pressure is actually harming the infected lungs. Obese people might need more pressure.

https://www.globalresearch.ca/are-ventilators-killing-more-people-than-saving/5709562

[NickorWan]

Sorry, that last bit should read 'Obese people might be receiving more pressure.'

[Peter Pedant]

aah - scientific question

and as so often - we dont know

you can look at the first 500 ( written up in the New England Journal and VERY useful) - but your starting and stopping rule must be known. - a series of X with NO deaths is not much good if the starting rule is after a death and the stopping rule is one before the next death

bring male - and handling wet fish ( yeah geddit?) were prominent but no one thought the place ( Wuhan Fish Market ) was the cause.

then in the next series - wet fish handling faded - and NOT being bear the fish market was prominent ( yeah geddit )
and that was the first clue that human to human transmission was occurring

sozza gozza ( and mozza and nozza oh and cockney tozza)

longish post on - - you can see an association but that does not mean one causes the other

wiv fat Barees - he looked pretty awful when he did the viddie of - "I am just going to hospital"
and I thought - " my god you havent been running the country have you?" and of course he hadnt

I was worried enough to go on a 1 000 cal diet
but of course that raises the question: "does recent loss of weight put you in the good prognostic category? or does it just convert you into a thin African who will die quicker from malnutrition?'

questions questions before we DDDIIIIEEE!

[aelmpvw]

i'm no expert but i would have thought it's because most obese people can't walk round the block without breathing heavy, having a virus attack their lungs isn't going to help

[pixie374]

Recent weight loss would still make a difference, yes. As Barry says, the strain is already there, so the easier you can make it on your body, the better.

[Peter Pedant]

the effect that Nickorwant describes is true and accurate
you will find it in West;s Patho Physiology of the Lung (*)

the analogy used is the steel slinky spring toy thing being held up from a surface . The bottom bit is scrunched up and in a fat fella ( I hesitate to use Buzzard) it is scrunched up more

this means for example that the blood to the bottom of the lung is getting less 02. - and much much more see WEST

ok That covers normal ventilation in a fat guy

(*) foo dat Paffo-fizz of da young someone quips instantly !
Clearly I am writing this for a walk in reader or a path-bot

[Peter Pedant]

the ventilators pump o2 at various concentrations into the lung

wonderful the patient gets up and walks around - er not quite (*)

and 1) see above the pressure may be greater if obese - BUT then women should be harder affected than men and they arent
2) it may not improve the blood and no o2 situation in the bottom of the lung - this is called a shunt and it may worsen the shunt
- so the patient goes bluer - - oo-er
3) the increased pressure may damage the normal lung = barotrauma

(*) why not den know-all expert? because I did this for 35 y)

[Peter Pedant]

and so from reading west
and my little tutorial - - what can one do?

well a)not ventilate - erk that is pretty radical. we have had ITUs for fifty years where you ventilate sick people and I know ! you send them to ITU and DON'T ventilate!
yeah right - only in America
but if you leave them until they almost croak and then intervene, then your little plan is self-fulfilling innit? I am gonna save your life by NOT putting you on a ventilator. Jesus

OK - lissive ventilation - god so long ago I have forgotten what that is
3) Prone ventilation - works - but do they do better, in the long run like survive more

4) quick small breaths - leaves the bottom of the lung untouched, hmmmmm - so the collapse bit remains collapsed. but less damage from baro-trauma

5) leave the ventilator NOI on empty - PEEP - and yes you can do high peep - mod peep - and low Peep. No one does no peep

6) Nitric Oxide (NO) bio transmitter - blue patients DO go magically pink - much better oxygenation - but no long term advantage if you do or you dont in a series ten years ago. damn. Not the wonder drug they first thought. May work in corona - do a few and see

and so on and so on
and the results seem terrible - at least 60% dying
and up to 80%

and that is why I have written - the retrained juniors are putting the patients on ventilators and watching them die
Not what the juniors thought ITU was gonna be all about - brain biopsies, CPR, appendicectomy, delivering babes, opening chests

just row upon row of ventilated patients half of which wont be there in 5 days

keep in and keep safe boys and girls

sozza - every one
some one asked about it and this is AN answer