(1/7) Q. Is obesity really a risk factor for #COVID19?
A. It’s not necessarily a risk factor for infection, but a small number of studies suggest individuals with BMI > 30 (defined as "obese") are more likely to be hospitalized than individuals with BMI <30.
(2/7) Other studies show that individuals considered obese are more likely to need ventilation or admission to acute and critical care units.
These patterns are especially pronounced among adults YOUNGER THAN 60/65 years of age (depending on the study)
(3/7)
Excess body fat can induce immune dysregulation and chronic inflammation which is linked to the #CytokineStorm responsible for Acute Respiratory Distress Syndrome in respiratory diseases.
Abdominal obesity, especially, can cause compress in the diaphragm and lungs.
(4/7)
What we don’t know so far:
Is obesity the only risk factor for worse progression? Or are there other underlying conditions that worsen progression? Studies have accounted for some other underlying conditions, but not all.
(5/7)
Are individuals who are obese less likely to seek care early on? Or could they have limited access to care?
If so, could these delays in care contribute to more severe presentation of disease at admission?
(6/7)
Would these findings hold up in an analysis of the general population which includes mild, asymptomatic individuals? So far, these studies are limited to people that interacted with the healthcare system, so we don't know if this trend hold in the general population.
1/ Q: Has almost everyone been infected with COVID by now?
A: Recent estimates suggest around 58% of the population in the US and over 70% in England have been previously infected, with BIG increases during the Omicron wave.
3/ ➡️ During the Omicron wave from December 2021-February 2022, this estimate increased from 33% to 58%.
➡️ Rates vary a lot by age, ranging from 33.2% for those over age 65 to 75% for those under age 18.
2/ Not likely. If your kids are suddenly getting sick a lot, this is likely due to “catching up” on exposures rather than a weakened immune system.
3/ Many families w/ young kids have been hunkered down for the better part of 2 years– a good % of a young child’s entire life. While isolation had *many* downsides, we can agree that not having to suction snot out of infant noses or clean up norovirus puke was a happy upside.
1/ Q: Are cases peaking? That means it’s all downhill from here, right?
A: Sort of…. Remember that even if cases come down as quickly as they rise, there will be as many cases *after* the peak as before (think area under the curve).
2/ ➡️ And if the downward slope is *slower* than the rise, we will see *more* cases during the decline from a surge.
3/ Burning fast could be a silver lining of super transmissible #Omicron. Cases rose & fell quickly in S. Africa (w/ hospitalizations & deaths still lagging). The UK appears to have turned the Omicron corner. Many US states appear past their peak in cases, w/ regional variation:
Unfortunately, this includes New Year’s Eve plans. The perfect storm of a new variant & holiday get-togethers is hitting communities & health care w/ FORCE! Testing is in short supply.
3/ Health care is under extreme pressure with surging cases. If you can avoid even one additional contact, you are helping. This is a temporary and urgent request (from a health care provider).