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Monday, March 23, 2020

Is obesity a factor in coronavirus deaths?

As many know, many people are obese. Hence the question has arisen: is obesity a factor in someone dying from the coronavirus?

Yes

On the one hand, I do think obesity is a factor. Obesity alone does decrease respiratory functional capacity and it does increase oxygen consumption.

In addition, someone who is obese likely has diabetes and hyperglycemia (undiagnosed or diagnosed). The hyperglycemic state could serve as a growth medium for microbes.

And the obese are sometimes immunodepressed.

No

On the other hand, I don't think obesity is the primary or sole factor. The leading cause of death in this coronavirus is acute respiratory distress syndrome (ARDS). However there are many obese people who have survived ARDS, heart failure, and hemophagocytic lymphohistiocytosis (HLH) in the context of active infection.

To be fair, modern medicine can work wonders.

Hypothesis

I suspect there might be a genetic issue involved. There have already been a number of deaths in the coronavirus due to a severe or exaggerated cytotoxic response aka cytokine storm (e.g. here, here). A cytokine storm on top of already diminished cardiorespiratory reserve in the obese.

Point being, perhaps different people's immune systems respond differently to the coronavirus. This could be a decisive factor in these deaths from coronavirus. Perhaps that's what makes a more fundamental difference in life or death at least among the obese.

Just a hypothesis. And hypotheses need to be tested.

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