Doctors at NYU Langone Health center conducted the largest study so far of U.S. hospital admissions for COVID-19, focused on New York City. They found obesity, along with age, was the biggest deciding factor in hospital admissions, which may suggest the role of hyper-inflammatory reactions that can happen in those with the disease.
RT @Mangan150: Obesity is the single biggest 'chronic' factor in New York City's hospitalizations
The logic here is that we've shut down the world's largest economy because of obesity.
Nearly eight percent of the U.S. population — close to 25 million people — has asthma, according to the Centers for Disease Control and Prevention. For people with asthma, the outbreak of a disease that can lead to respiratory failure was particularly worrisome. Many health organizations have cautioned that asthmatics are most likely at higher risk for severe illness if they get the virus. But data released this month by New York State shows that, only about five percent of Covid-19 deaths in New York were of people who were known to also have asthma, a relatively modest amount.
Over the last decades, adipose tissue has been identified as a metabolically dynamic endocrine organ and an important source of several hormones, cytokines, chemokines, growth factors, and complement proteins. These substances play a central role in whole body homeostasis by influencing a variety of biological and physiological processes. They are control of food intake, energy balance, insulin action, lipid and glucose metabolism, angiogenesis and vascular remodeling, blood pressure, and coagulation.
This is not the first time a cytokine storm has been linked to a pandemic. Scientists suspect that cytokine storms caused many of the fatalities in the [1918 flu pandemic](https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm) and the [2003 outbreak of SARS](https://www.cdc.gov/sars/about/fs-sars.html#outbreak), a virus related to the one that causes Covid-19. More recently, Cron and colleagues analyzed 16 fatal cases, from between 2009 and 2014, of the [pandemic H1N1 “swine” flu](https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html) — a novel influenza virus that emerged in 2009 and has since become a fixture during flu season. Up to four-fifths of those patients met standard criteria for a cytokine storm. In addition, several had genetic variants that [might have made their immune systems more likely to overreact](https://academic.oup.com/jid/article/213/7/1180/2912147).
Two patients, for example, had mutations in the PRF1 gene, which makes a protein called perforin. Made by certain immune cells, perforin [pokes holes in other, infected cells to destroy them](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439970/). More than 90 PRF1 gene mutations have been identified in people with familial [hemophagocytic lymphohistiocytosis](https://www.researchgate.net/publication/236940534_Novel_Mutations_in_the_UNC13D_Gene_Carried_by_a_Chinese_Neonate_with_Hemophagocytic_Lymphohistiocytosis) and [predisposition for leukaemia cancers](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5006901/). These mutations result in the production of a defective perforin protein or prevent the production of perforin. Mutations in the perforin gene impede the process, but these immune cells — known as natural killer cells — don’t stop trying. "*They just keep banging their heads against this, secreting all these cytokines, and you get a cytokine storm*,” says study collaborator Grant Schulert, a pediatric rheumatologist at Cincinnati Children’s Hospital Center, who co-wrote an overview of [one kind of storm and potential treatments](https://www.annualreviews.org/doi/10.1146/annurev-med-061813-012806) in the Annual Review of Medicine.
And five of the patients looked at by Cron and colleagues carried mutations in a gene called LYST (also known as CHS1), which causes defects in trafficking of cellular garbage within lysosomes. Lysosomes act as recycling centers within cells. They use digestive enzymes to break down toxic substances, digest bacteria that invade the cell, and recycle worn-out cell components. Their disruption breaks the activity of perforin and [prevents immune cells from responding properly to invaders.](https://ghr.nlm.nih.gov/gene/LYST#conditions) A handful of others had mutations that the scientists suspect might also influence immune function.
It’s possible, Cron says, that these or similar mutations might explain why about 20 percent of people [get a severe or critical version of Covid-19](https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf), while others have milder symptoms or even no symptoms at all. Those whose genomes carry such a mutation might, unknowingly, possess an immune system primed to get out of control, so they’d get sicker than everyone else.
“*It’s hard to fight off infections when your immune system is being trashed*,” Cron says. Trashed by which (https://www.reddit.com/r/Physics_AWT/comments/8nzp5l/deconstruction_of_gmo_hype/), (https://www.reddit.com/r/Physics_AWT/comments/a279er/deconstruction_of_gmo_hype_ii), (https://www.reddit.com/r/Physics_AWT/comments/bw784x/deconstruction_of_gmo_hype_iii), (https://www.reddit.com/r/Physics_AWT/comments/e63303/deconstruction_of_gmo_hype_iv/)?
Covid makes getting oxygen a bitch (I had it but needed no medical intervention), fat is just an oxygen sink, your body has to keep all that fatty mass alive. Suddenly you get covid and cant keep your organs and fatty mass alive, and if either dies your screwed. (I'm skinny, and fit, and lucky I guess)
Looking at the chart they don't breakdown the percentage of obese people that have comorbidities like diabetes or heart disease. Obese people have comorbidities so why don't they include that critical information?
One of the best explanations (breaking it down Barney style) I've heard/read/watched is that is is not the obesity that is a risk factor. The risk factor is the body's reaction (vascular inflamation) to ingesting particular types of food (starches & sugars) that additionally have the effect of making people obese. So the obesity is merely the indicator that your body's immune system is likely hyper-vigilant (vasular inflamation) and will over react to the COVID-19 virus when it encounters it. That over reaction causes damage to organs.
Or maybe people are eating too much calories therefore becoming obese and developing health problems.
“Cico” calories in calories out. Prove me wrong and don’t bring up the less than 1% that has legitimate metabolism problems when everyone that doesn’t thinks they do
As a fat guy from America, this is so dumb to deny. Luckily I don't have other conditions, but c'mon, I know being big isn't healthy. My only gripe is how people want to blame every fat person like it's solely their fault. Everyone has a different metabolism, if I even look at bread I gain weight.
Then you ever notice how being fat has kinda slid down the class system to poor people.
People ask how people can starve, everyone has a dollar menu!
Then people want to get mad at fat poor people, when the solution to hunger was having their sole nutritional source being fried food and processed meat.
Can also put points against a shit public education system were home economics is baking cookies and sleeping.
We wonder why people come out of it with no life skills.
[But you can't entirely blame a sluggish metabolism for weight gain, says Dr. Lee. "The reality is that metabolism often plays a minor role," he says. "The greatest factors as you age are often poor diet and inactivity."](https://www.health.harvard.edu/staying-healthy/the-truth-about-metabolism)
[Using this technique multiple studies have all arrived at the same disappointing results, people vastly underestimate their calorie availability and dramatically overestimate their calorie usage. The reasons seem tied to factors like the weight of the individual, income, education level, whether they are male of female and psychological issues. The degree of error can be quite large, ranging from almost 800 to over 2,000 calories a day.](http://calorielab.com/news/2014/07/23/doubly-labeled-water-calorie-estimates/)
While I like both these studies it doesn't address both of my last two points. Many people to old, or poor don't have access to the internet to get high quality information like this as well. Please don't bring up Obama phones if you haven't tried using one out in the middle of nowhere.
The only reason I ever got a handle on my weight is learning how to cook, which didn't happen intill i was 27. And to be honest, even the cheaper home made meals are more expensive than the dollar menu. But that's because it's really food and not processed meat with meat filler.
It's also a great deterrent that if I just want to stuff my face, I actually have to spend time making the food lol.
Cheers though, stay safe.
It's a tough pill to swallow, but it's true. I'm a person who has been on both sides of the river, weight-wise, and when I was significantly overweight, every other health complication I had was just that much worse, especially when it came to infections that affected the respiratory tract. I can only imagine that something that hits it as hard as COVID-19 does would complicate things that much more.
ZDnet title seems a bit off, as first factor in their decision tree is age, not obesity. Also, this doesn't appear to attempt to unwind causation vs correlation. As I read it, it's just, if you could only ask a few questions to make your decision, what should you ask first? Useful for admitting, but probably less so for understanding what's actually going on.
Looking at the numbers in the paper, high blood pressure, for example, seems like a powerful predictor of problems. Presumably that's captured by the obesity question, even though those two conditions are only partially correlated.
Also interesting is that they don't see race as a factor. Other reports seem to indicate that African Americans are doing significantly worse.