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      Obesity and COVID-19 mortality are correlated

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          Abstract

          In view of a conspicuous absence of any cross-country study linking obesity and COVID-19 mortality, we conduct an empirical analysis of plausible associations between COVID-19 mortality and the proportion of obese in the adult population distributed across 142 countries around the globe. We observe a statistically significant positive association between COVID-19 mortality and the proportion of obese in adult populations spanning 142 countries. This association holds across countries belonging to different income groups and is not sensitive to a population’s median age, proportion of the elderly, and/or proportion of females. The estimated elasticity of COVID-19 mortality, with respect to the proportion of obese in adult populations, is the highest for the sub-sample of countries that belong to the high-income group. While limits of confidence intervals around the point estimates of these elasticities range between 0.7 and 2.1, on an average, every percentage point increment in the proportion of obese in adult populations contributes to an additional 1.5% points to COVID-19 mortality for high income countries. A positive association, observed between COVID-19 mortality and the proportion of the obese in a country’s adult population, is robust subject to alterations in the conditioning information set on age, gender, and income.

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          Covid-19 in Critically Ill Patients in the Seattle Region — Case Series

          Abstract Background Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020. Methods We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up. Results We identified 24 patients with confirmed Covid-19. The mean (±SD) age of the patients was 64±18 years, 63% were men, and symptoms began 7±4 days before admission. The most common symptoms were cough and shortness of breath; 50% of patients had fever on admission, and 58% had diabetes mellitus. All the patients were admitted for hypoxemic respiratory failure; 75% (18 patients) needed mechanical ventilation. Most of the patients (17) also had hypotension and needed vasopressors. No patient tested positive for influenza A, influenza B, or other respiratory viruses. Half the patients (12) died between ICU day 1 and day 18, including 4 patients who had a do-not-resuscitate order on admission. Of the 12 surviving patients, 5 were discharged home, 4 were discharged from the ICU but remained in the hospital, and 3 continued to receive mechanical ventilation in the ICU. Conclusions During the first 3 weeks of the Covid-19 outbreak in the Seattle area, the most common reasons for admission to the ICU were hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both. Mortality among these critically ill patients was high. (Funded by the National Institutes of Health.)
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            Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

            Summary The linkage of individuals with obesity and COVID‐19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID‐19, 75 studies were used to conduct a series of meta‐analyses on the relationship of individuals with obesity–COVID‐19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID‐19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID‐19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID‐19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.
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              Impact of Obesity on Influenza A Virus Pathogenesis, Immune Response, and Evolution

              With the rising prevalence of obesity has come an increasing awareness of its impact on communicable disease. As a consequence of the 2009 H1N1 influenza A virus pandemic, obesity was identified for the first time as a risk factor for increased disease severity and mortality in infected individuals. Over-nutrition that results in obesity causes a chronic state of meta-inflammation with systemic implications for immunity. Obese hosts exhibit delayed and blunted antiviral responses to influenza virus infection, and they experience poor recovery from the disease. Furthermore, the efficacy of antivirals and vaccines is reduced in this population and obesity may also play a role in altering the viral life cycle, thus complementing the already weakened immune response and leading to severe pathogenesis. Case studies and basic research in human cohorts and animal models have highlighted the prolonged viral shed in the obese host, as well as a microenvironment that permits the emergence of virulent minor variants. This review focuses on influenza A virus pathogenesis in the obese host, and on the impact of obesity on the antiviral response, viral shed, and viral evolution. We comprehensively analyze the recent literature on how and why viral pathogenesis is altered in the obese host along with the impact of the altered host and pathogenic state on viral evolutionary dynamics in multiple models. Finally, we summarized the effectiveness of current vaccines and antivirals in this populations and the questions that remain to be answered. If current trends continue, nearly 50% of the worldwide population is projected to be obese by 2050. This population will have a growing impact on both non-communicable and communicable diseases and may affect global evolutionary trends of influenza virus.
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                Author and article information

                Contributors
                chakra@uwm.edu
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                11 April 2023
                11 April 2023
                2023
                : 13
                : 5895
                Affiliations
                [1 ]GRID grid.67033.31, ISNI 0000 0000 8934 4045, Tufts University School of Medicine, ; Boston, MA USA
                [2 ]GRID grid.215352.2, ISNI 0000000121845633, University of Texas at San Antonio, ; San Antonio, USA
                [3 ]GRID grid.267468.9, ISNI 0000 0001 0695 7223, University of Wisconsin-Milwaukee (UWM), University of Wisconsin, ; 836 Bolton Hall, Milwaukee, WI 53201 USA
                [4 ]GRID grid.267468.9, ISNI 0000 0001 0695 7223, Affiliated Faculty, , Northwestern Mutual Data Science Institute, UWM, ; Milwaukee, USA
                Article
                33093
                10.1038/s41598-023-33093-3
                10088638
                37041203
                9be43538-04d6-4cab-a04d-733b204b4dfb
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 28 December 2022
                : 6 April 2023
                Categories
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                © The Author(s) 2023

                Uncategorized
                diseases,infectious diseases,viral infection
                Uncategorized
                diseases, infectious diseases, viral infection

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