Week 3 of social distancing
With each new day of the corona pandemic, the total numbers of infections, hospitalizations, deaths and recoveries increase. And with each increase in numbers, there is more insight. In the infection rate, the ratios of admission and death, the risk factors for serious complaints or IC admission, and the chance of building up immunity without serious complaints. We devour the numbers. We want to know. To understand, to learn, to reassure ourselves or others, and to look ahead and take action.
The COVID-19 (corona virus disease 2019) case in China and Italy gained us many insights. It are mainly the elderly who develop serious complaints when infected with the COVID-19 virus, who are admitted to hospital and die. More than half of all reported infected persons hospitalized in the Netherlands are over 70. And even > 80% of the patients who have died so far happen to be in that age category1.
Younger people can certainly get very sick from this new coronavirus. However, the predominantly advanced age in the most serious cases leads us to be highly concerned about our parents and grandparents. And maybe less about ourselves or our children.
Next, it appears that people who are admitted because of serious corona complaints often also have another condition, changing our image of the corona patient. Reports show that in the Netherlands more than 64% of serious COVID-19 patients also suffer from another disease1. Often these are conditions such as cardiovascular disease, chronic lung disease, diabetes, immune disease or cancer. Age is still the biggest risk factor for developing serious complaints upon corona infection. And yet, in your mind you also wonder who of your family and friends is considered vulnerable. Your brother with high blood pressure, that girlfriend with respiratory complaints, the neighbor with diabetes, you?
Since last week, in addition to age and comorbidity, another characteristic has increasingly been mentioned as a risk factor for the development of serious complaints of COVID-19 infection: obesity.
In the 70-85 age group, approximately 60-70% are moderately to seriously overweight2. Obesitas is slightly more common in men than in women. Since many people in this age group are hospitalized, it is not surprising that proportionally more obese patients are seen (just as, based on this age group, the number of balding or gray patients in IC will be high).
But a strikingly high number of obese patients has been observed in the IC population. The numbers vary, partly depending on which definition of obesity is used, but the percentages do not lie: 80-90% of corona patients are overweight! This observation was voiced in television program Jinek3 last week, and has been covered in various media since. Headlines such as "Survival starts with a healthier lifestyle and food" in Het Parool4, "Our lifestyle is now breaking up our care and economy" in Telegraaf5 and "Obesity as a risk factor for corona infections" in the FD6.
We are worried. Because we wonder why obesity gives such a high chance of serious COVID-19 complaints? And what if I am overweight? What does that mean for the risk of a bad prognosis if I catch the virus? We want to know more.
In addition to statistical and epidemiological research, many (clinical) micro and cell biological research is also carried out into COVID-19. Scientific explanations are sought that explain why being overweight is such a huge risk factor. There are physical aspects of obesity (Body Mass Index> 30), such as more pressure on the chest, which makes breathing extra difficult for complaints. In addition, obesity also often appears to be associated with stress in the immune system. As a result, an overweight person may be more susceptible to catching the virus and developing serious complaints. In articles in Dagblad van het Noorden6 and Leeuwarder Courant7, researchers at the UMC Groningen describe that the COVID-19 virus enters lung cells via the ACE2 receptor. These are proteins on the outside of cells. The coronavirus loves these. The virus is particularly fond of ACE2 receptors in the lungs. The more fat tissue, the more ACE2 receptors, the more room for the virus to cause damage. The amount of adipose tissue seems to be the culprit.
This angle is also widely investigated internationally. In the past week alone, more than 20 publications have appeared in international scientific journals, describing (part of) the mechanism of the virus interaction with (fat) cells.
And many more research results and insights will follow. About the mechanism of action of SARS-CoV-2 (the scientific name of the coronavirus), the degree of infection, the risk factors, the measures on how we can protect ourselves and others.
Corona keeps us busy. We want to know. To understand, to learn, and to know if you are at risk. You want to take action and consciously work on your health and prevent or get rid of obesity. Clear. can help you with that.
Our programs are now fully online. You can start any time (as an individual). You can also join a group at the beginning of each week (good for motivation, community feeling and knowledge sharing). For more information on the Clear. Nutrition Program go to www.clear.bio or take a deep dive in our knowledge base.
If you have any questions, let us know. We are there for you and for your health.
Stay safe & stay healthy,
Madelon, Head of BioScience
Note: all sources used are in Dutch