Stephen O'rahilly recently spent a week in a hospital, sick with Covid-19 and struggling to breathe.
"My lungs were very affected," says Rahilly, 62, who spent almost a week receiving extra oxygen in what is known as a high intensity care unit in UK
The experience led you thinking: while about 80% of covid-19 cases can be treated at home, why some people, including it, end up with more severe infections?
Beyond his age, O'rahilly knew he had another strike against him when it comes to Cuvid-19 infection: your weight. IMC, or body mass index, has more than 30 years.
o'rahilly, which directs the MRC metabolic disease unit at the University of Cambridge, is considered one of the leading obesity surveys in the world. He was bitter in 2013 by Queen Elizabeth II for his work, which includes the discovery of a genetic condition that steals the body of hormonal leptin, which controls appetite and weight.
And so after the brush with coronavirus, he began to dig exactly what is about obesity that makes it so risky for a Cuvid-19 infection.
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It has become clearer that people who are obese are one of the groups with the highest risk of the disease, regardless of their age. CDC recently refined their risk categories for Covid-19, stating that obesity was such a large risk to Covid as having a deleted immune system or chronic lung or kidney disease. The Agency also lowered the bar to where this risk begins - from an IMC of 40 to an IMC of 30. Approximately 40% of Americans have an IMC above 30.
CDC change in CDC risk Come after a British study of more than 17 million people have discovered that people living with severe obesity were twice as prone to die from Covid-19 as people who were not obese. This was true, even after other things like their age and sex were taken into account. The study also discovered that risk increases with the degree of obesity. The greater the person, the greater the risk of a death covid-19.
during the 2009 pandemic H1N1 influenza, there was a strong link between obesity and bad results for patients. People with obesity were at greater risk of dying during the flu pandemics in the 1950s and 1960s as well.
Markers suggest the reason So why is it? Some people say being heavier only makes it harder to breathe, especially when you are sick.
"on the radio, you heard the people making really easy comments about big bellies and pressing the diaphragm and bad for ventilation and simplistic thoughts about why obesity can be associated with bad results, and I wondered about it "O'rahilly says:" And I thought it was A bit unlikely. "
Instead, it thinks that the risk comes from the fact that fat does and regulates hormones.
For example, people who are obese do more something called "complement" proteins. These proteins can trigger blood clotting out of control, which is a problem in patients with serious Covid-19.
People with obesity also have lower blood levels of a hormone called Adiponectin. Recent studies in mice show that adiponectin protects the lungs. O'rahilly thinks that if you have lower levels to get started, it may be more likely that you have pulmonary inflammation during an infection like Covid-19.
Adiponectin also helps maintain clean and open blood vessels.
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a mixture of problems So if the interior of its blood vessels are sticky, and a virus causes its immune system to be Haywire and create more blood clots, which defines the stage for locks. These blockages can cause heart attacks, spills and pulmonary damage - all problems seen in patients Covid-19.
To aggravate the problem, people with obesity seem to have more ACE2 receptors in their cells than others. ACE2 receptors are the ports that the virus uses to infect cells and then do more copies of themselves.
A recent study found that fat tissue has more ACE2 receptors than pulmonary cells. More Ace2 can mean more viruses in the body, says Carl Lavie, MD, medical director of cardiac rehabilitation and prevention at Ochsner Health in New Orleans.
Lavie recently published an article on obesity and Covid-19 in the Mayo Clinic process.
At the top of all this, there is insulin resistance, which is more common in people who are obese and may further appear the ACE2 receptors.
Insulin is a hormone that is critical to maintaining blood sugar levels. In obesity and some other conditions, body cells stop also responding to the message of insulin to use sugar as energy and take it off blood and instead stores it as fat. In response, the pancreas tries to increase the volume, linking more insulin. The problem is that insulin does not only impose blood sugar levels.
"One of the things that affects is the Ace2 receptor that this virus binds," says Francis Finucane, MD, an endocrinologist at Galway Hospital University in Galway, Ireland.
"If you are insulin resistant, you have more receptors for those peak proteins on your cellular surfaces, say, for example, in your pulmonary cells," he says.
It says that researchers are planning studies that will try to prove some of these theories.
Insulin paper Your team will try to measure insulin resistance in patients from Covid-19 through blood tests, so see how sick they are.
Funcane admits that it may not show anything. The disease can make people resistant to insulin. So they may be measuring an effect of infection and not a cause.
A team different from researchers at U.K. is taking a different approach. They are going to my data on tens of thousands of patients to see if genes for insulin resistance are linked to the severity or survival of Cuvid-19.
Learning the causes of the root can help doctors develop strategies to help protect obese patients. For example, there are ways to improve insulin sensitivity relatively rapidly through diet, physical activity and drugs.
"I'm being facetious here, but we may need to prohibit chocolate and sugary drink to reduce the population risk of Covid-19," says Finucane.
