in the United States, obesity, an aggravating factor that could be devastating

In Marrero, Louisiana, March 17. Jonathan Bachman / REUTERS

The figures are still lacking, but Professor Eric Ravussin, obesity specialist and associate director at the Pennington Biomedical Research Center, in Baton Rouge (Louisiana), is convinced: obesity, often linked to other pathologies, notably respiratory or immune, will have a devastating effect on the death rate of people affected by the coronavirus in the United States.

The proportion of obese and overweight people is one of the largest in the world. According to epidemiological studies, 39.8% of adults are obese and 31.8% are overweight; obesity is also observed in 14% of children aged 2 to 5 and in 21% of 12-19 year olds. Other calculation methods even estimate that 42% of American adults are obese, including 9% with severe obesity.

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Researchers do not currently have general data, but local studies indicate a trend. "In a hospital in La NouvelleOrleans, 60% of critical cases concern obese people ", indicates M. Ravussin, who nevertheless underlines the small sample studied. A correlation is already notable: Louisiana is both a state with an obesity rate above the national average and, with New York, one of the hardest hit by the pandemic.

Increased pressure

To warn of this particular risk in the United States, experts also rely on known figures from the H1N1 epidemic in 2009, during which obesity was a factor in excess mortality. In California, a study had shown that out of 268 hospitalized or deceased patients, 58% were obese and, among them, two thirds had severe obesity. Two-thirds also had diabetes, lung or heart disease. "But even the metabolically healthy obese are at risk because their immunity is compromised », Specifies Mr. Ravussin.

The Obesity Society, of which the Baton Rouge professor is one of the officials, is concerned about the " collision between two public health epidemics in the United States: obesity and Covid-19, interacting to further exert pressure on (their) health system ". The treatment of obese patients requires special equipment (bed, transport, etc.) and more complicated care to implement, in terms of intubation and diagnosis.

"We will see a sharp increase in the number of deaths in this country, compared to what happens elsewhere"

The same fear was recently raised by doctor Michael Osterholm, an infectious disease expert at the University of Minnesota, on a radio in Minneapolis: "We are going to see a sharp increase in the number of deaths in this country, compared to what is happening elsewhere, due to this unique risk factor (the number of obese people). "

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The Centers for Disease Control and Prevention (CDC), which ranks obesity as an aggravating factor for Covid-19, has analyzed 7,000 affected patients across the country. If they do not particularly emphasize obesity in the pathologies observed, they indicate that 78% of people cared for in an intensive care unit already suffered from heart, lung, immune or renal disease, or diabetes. This is also the case for 71% of people hospitalized without respirators.

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