Two Pandemics Coalition: Covid-19 and Obesity

Abstract

COVID-19 epidemic caused by an influenza-like virus strain (SARS-CoV-2) invaded the world. The World Health Organization (WHO) announced this infection outbreak as a global pandemic on 11 March 2020. From one day to another the number of new cases is growing and also the number of deaths. This infection emerged earlier in Wuhan City and rapidly spread throughout China and around the world since December 2019. Another silent pandemic disease spreading mainly in industrialized countries is obesity. The best example is US were about 34% of the Americans are obese.In actual context, it can be said there is a coalition of 2 pandemics. In Romania, obesity and overweight prevalence assessed by Predatorr study is at a high level: 34,7% overweight and 31,9% obesity. Systemic inflammation in obesity is the central mechanism leading to lung function decline. There are two main questions a) is obese more sensible to viral infection or b) potentially more contagious? The answer is positive to both. Recent WOF official position stated that obesity is a risk factor for developing severe forms of COVID-19. Donna Ryan’s message, as president of World Obesity Federation WOF, US emphasized at the beginning of April the risk for severe complications for persons with obesity who contracted the infection with SARS-CoV-2. Nutritional support in COVID-19 should prefer oral feeding, whenever is possible. A special attention should be dedicated to a healthy microbiome and intestinal immunity. Energy intake should be 25-30 kcal/body weight, with 1.2-2 g/kg proteins. Enteral nutrition will be recommended in severe cases. Evidence is supporting the recommendation that for people at risk of developing COVID-19 to consider for few weeks a dosage of 10000 UI/day of vitD3, than a maintainance dose of 5000 UI/day. The target must be to stabilize a level of 40-60 ng/ml for 25(OH) D concentration. Pulmonary rehabilitation, smoking cessation, included in a healthy lifestyle will be further steps after patients recovery from this infection.Facing this pandemic coalition, our messages should be stronger in stimulating prevention of obesity. Since more than a half of Romanian population is already overweight or obese, healthy lifestyle should become a daily prescription, not just a luxury recommendation. Daily, right messages from doctors acting like role models, in a partnership between general practitioner and other specialties like diabetologists, pneumologists, cardiologists, nutritionists will be efficient weapons against this cruel coalition: Obesity and COVID 19.

Factors Associated with Increased Morbidity and Mortality of Obese and Overweight COVID-19 Patients

“…Meanwhile, each study’s characteristics related to study design characteristics of the patients and location of the study. We specified the extracted comorbidities of cardiovascular disease, hypertension, and dyslipidemia by other systematic reviews and meta-analysis according to the recognized co-morbidities for obesity and COVID-19 [ 15 , 16 ].…”

“…The coronavirus disease (COVID-19) pandemic is triggered by the influenza-like strain of the virus (SARS-CoV-2) [ 15 ] that causes acute respiratory infection, including a wide range of diseases, from asymptomatic infection to severe acute respiratory damage, in about 20% of patients receiving healthcare [ 16 , 31 ]. The WHO has been notified on 31 December, 2019 that a new virus belongs to the coronavirus family [ 32 ].…”

“…Hâncu and Mihălţan [ 15 ] hypothesized that the quarantine era may be characterized as an “obesogenic” era, where sedentarism is preferred, whereas there is increased propensity to consume hypercaloric foods, which are consumed unconsciously due to stress. Abbas et al [ 3 ] asserted that with the continuation of the COVID-19 pandemic, there will be a decline in dietary supplements with an increased tendency for food storage and increased use of canned food and ultra-processed items because of their safe processing and packaging, as well as the probability of eating in their other activities.…”

“…The aim must be to sustain a concentration level of 40–60 ng/mL at 25(OH) D. The potential benefits of mass quarantine should be carefully monitored to improve cardiovascular risk over the long term. An unhealthy lifestyle and anxiety should be carefully addressed [ 15 ]. This is particularly challenging with current stay-at-home guidelines limiting activity levels—the “lockdown cost of weight gain”.…”

COVID-19 pandemic: Changes in the emotions, body weights and nutrition habits of individuals during social intervention measures

“…It is known that people tend to consume delicious foods with high energy content, especially during periods of high anxiety and stress levels such as the Covid 19 pandemic [28]. The pandemic period has started to be counted as an obesogenic environment due to the negative effects on the physical activity levels as well as the negative effects on the eating habits [29]. Studies have shown that stress stimulates the consumption of delicious food in approximately 30% of the population [30,31].…”