COVID-19 UPDATE APRIL 1, 2020

The latest data from front lines of the COVID epidemic seem to link poor outcomes with obesity.

That is, it seems that the heaviest patients (e.g. BMI > 30) have the greatest likelihood of respiratory failure and need for ventilator support. It may prove out that a younger person with a higher BMI actually will have a higher risk of death from respiratory failure than a much older, thinner patient.

This trend seems to be even worse in the obese pre-diabetic or diabetic patient. Thus, the connection between obesity and physical deconditioning that is typical of the sedentary high BMI person may be the key not to who gets COVID, but rather to who succumbs.

Adult onset diabetes is by definition a state of insulin resistance. The high insulin levels and inflammatory markers may predispose to viral entry into lung cells. These are areas that are actively being researched now and hopefully will provide useful avenues for future therapies to ameliorate the disease.

I personally wonder if this helps to explain the seemingly low incidence of Covid-19 deaths in India, whose population is definitely on the low end of the BMI scale….this remains to be seen obviously but it is an intriguing potential link.