COVID-19 Comorbidity

Researchers in Lille, France studied patients admitted to intensive care for COVID-19 and concluded that Obesity is a risk factor for severity. It has been recommended that quarantine of obese subjects be extended longer than nonobese patients.[1]

Black Americans are being disproportionately affected by COVID-19.[2]  The increased incidence of obesity among the Black population who are concentrated in our inner cities is most likely responsible.

Diabetes mellitus modulates host immune response and host-virus interaction to increase morbidity. [3] As it is the visceral or “belly fat” within the abdomen which secretes resistin, a cellular hormone which antagonizes the body’s own insulin to cause type 2 diabetes, reducing the size of that noxious cytokine factory which functions as a life-shortening gland with Endoscopic Visceral Lipectomy is potentially a direct approach to the problem if carried out sufficiently ahead of time.

A societal effort must be made to reduce the vulnerability of these obese and diabetic sectors of the population to COVID-19 and future pandemics. Obesity, metabolic syndrome and type 2 diabetes need not just to be maintained under control, but efforts should be made to prevent, eliminate and cure them. 

Governments need to make existing modalities and treatments available to everyone, especially those in inner cities, or these hosts will remain as soft targets and as breeding pools for the next pandemic. They will comprise the majority of admissions and fatalities. Fortify the herd or nature will cull it at our expense.

[1]  High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, Labreuche J, Mathieu D, Pattou F, Jourdain M; Lille Intensive Care COVID-19 and Obesity study group. Obesity (Silver Spring). 2020 Apr 9. doi: 10.1002/oby.22831. [Epub ahead of print]

[2] https://theblackwallsttimes.com/2020/04/05/covid-19-more-deadly-to-black-americans/

[3] COVID-19 Pandemic, Corona Viruses, and Diabetes Mellitus. Muniyappa R, Gubbi S. Am J Physiol Endocrinol Metab. 2020 Mar 31. doi: 10.1152/ajpendo.00124.2020. [Epub ahead of print] PMID: 32228322

The Risk of Birth Defects to Children of Obese Mothers Reduced by Weight-Loss Surgery

In a recent article in JAMA, the risk of major birth defects was found to be about 30% lower in children whose mother had weight-loss surgery than in children of obese untreated women. [Neovius M, et al. JAMA. 2019;doi:10.1001/jama.2019.12925].

Swedish researchers examined data on more than 33,000 births between 2007 and 2014. The risk of major birth defects was 4.9% in children born to untreated obese women as compared to 3.5% among normal weight women. But the risk of major birth defects was reduced to 3.4% in the children born to women who had gastric bypass surgery.

This research serves to assuage fears that bariatric surgery creates nutritional deficiencies which might increase the risk of birth defects and can’t be satisfactorily managed by patients taking their recommended nutritional supplements.

Cleveland Clinic Study Finds Weight Loss Surgery Decreases Risk of Heart Attack and Stroke

Dr. Steven Nissen and colleagues compared the impact of various types of bariatric surgery on almost 2,300 people to the usual medical care on more than 11,000 obese patients with similar symptoms treated between 1998 and 2017 at the Cleveland Clinic.

Those having bariatric surgery lost more weight and had fewer heart attacks, fewer strokes, a lower incidence of kidney and heart failure, a lower incidence of atrial fibrillation, lower blood sugar levels, and experienced a 41% lower over all morbidity during the study.  Additionally, those who had surgery used fewer medications for diabetes and other conditions.

The researchers concluded that many of the deleterious effects of obesity are potentially reversible.