Overweight and Covid: I used wet gauze to wipe the fluid on her face after the last first aid failed.

Her face in her twenties became calm and likable like she used to be. Come on, me. I no longer have to be in pain. We also did our best. I also tried my best.

At the center of the epidemic, I broke a lot of things. The first surprise that caught my eyes was that the people who died from Covid in this epidemic were mainly not old, not with underlying diseases. At our Binh Duong frontline hospital, most of the dead were young, mostly overweight and obese.

Vietnamese culture still gives people who are overweight a sympathetic look. Usually they are likable and kind people. But now I see a lot of fat people dying from Covid. Slowly, their condition worsened. At first, he only needed to breathe oxygen gently, but only a few days later he had to give the highest level of oxygen, then had to put in a ventilator, and then a few days later he left.

Caring for people who are obese, roll over, change diapers requires more manpower, venous removal is almost impossible, and central venous catheters must be placed. They had difficulty breathing, could not lie on their stomachs because their stomachs were too big… And above all, the test showed that the reaction of the cytokine storm in the body was very strong, devastating the lungs, destroying many organs.

This the world has known for a long time. World Health Organization Secretary-General Tedros Ghebreyesus once said, “The correlation between obesity and mortality from Covid-19 is clear and convincing”. Statistics show that, of the 2.5 million people who died from Covid, 2.2 million were in countries with a high percentage of overweight people. According to The Guardian, 80% of Covid patients in the Serviced apartment in ho chi minh city intensive care unit are overweight and obese. In the US, this figure is even 88%.

Vietnam last year had the lowest Covid death rate in the world, most likely because at that time the epidemic had only swept through areas with many thin people. This time, the epidemic swept through the southern key economic region, where the proportion of overweight people was the highest in the country. The mortality rate immediately spiked above 2.5% compared with the world average of 2.1%. If Ho Chi Minh City alone, the mortality rate is even higher, approximately 4%.

The mechanism of death from Covid has gradually become clear, people die from Covid mainly because of a cytokine storm that occurs when the body overreacts to the virus. About 80% of people infected with Covid have an immune system that responds just enough to clear the virus, and they experience a mild illness. The remaining 20% ​​of infected people showed quite severe symptoms, requiring hospital treatment and some of them did not survive.

Why are overweight people more likely to die when infected with Covid?

Many studies show that obese people have severe metabolic disorders, so the immune system is susceptible to disordered responses. For decades, the medical world has changed its view of adipose tissue. Fat cells and adipose tissue are no longer known only as energy stores, but a new realization has been introduced: adipose tissue is considered as endocrine organs.

In the 1990s, science discovered that adipose tissue secretes Leptin – the hormone that regulates energy metabolism. Next, the scientists discovered that adipose tissue also secretes a lot of cytokines, including those with strong inflammatory and destructive activities such as IL6, TNFα. These cytokines are the culprits that cause the cytokine storm in the lungs of people with Covid.

Normally, adipose tissue secretes a small amount of cytokines and the balance between inflammatory and anti-inflammatory cytokines keeps our body healthy. When infected, the immune system is mobilized, the giant fat blocks in the body are also awakened, and they have produced an excessive amount of cytokines, which is harmful to the body. In addition, when sick, the body has a high demand for energy, but often starving, fat blocks are then mobilized to break down Triglycerides into energy, which also produces bad metabolism.

From the experience of treating hundreds of the most severe Covid patients in the past few days and consulting medical documents, I can almost confirm: being overweight is very easy to die when infected with Covid.

It is also a new issue for public health. Early introduction of a universal health care strategy and promotion of healthy lifestyles and obesity reduction in young people is also an important national requirement.

Let’s quickly lose weight, so that if we get infected with Covid, we will be lighter. And I think that overweight people should be encouraged and given priority to get vaccinated as soon as possible.