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Obesity is now considered a disease of civilization, and the latest WHO data indicate that this problem affects as much as 13 percent. the adult population of the world. Scientists noted in the spring that obesity was adversely affecting COVID-19, and are now wondering whether it will weaken the effect of the vaccine. Their doubts are justified because, for example, studies on the effectiveness of vaccines against influenza, hepatitis B and rabies indicate that they are less effective in obese people.
- Experts say the levels of ACE2 receptors that the SARS-CoV-2 conoravirus uses to access cells are high in adipose tissue, putting them at greater risk of infection
- Chronic inflammation in the body of obese people adversely affects their immune response to SARS-CoV-2 virus
- Influenza vaccines have been shown to be less effective in obese people
- Americans and Brits Consider Including People With High BMI In The Group To Be Vaccinated Against COVID-19 First
- You can find more up-to-date information on the TvoiLokony home page
– Not all vaccines work properly in obese people. This raises suspicions that the COVID-19 vaccine may not provide adequate protection, says Dr. Donna Ryan, who studied obesity at the Pennington Biomedical Research Center in Baton Rouge.
Clinical trials are ongoing, but scientists are not sure that they were designed to capture this problem.
“In the case of the flu, we see that vaccination does not work well for obese people,” says epidemiologist Lin Xu of Sun Yat-Sen University in Guangzhou, China. – However, we do not yet have data on the coronavirus.
It was clear from the outset of the pandemic that obesity increased the risk of a more severe course of infection. When Dr. Lin Xu analyzed the data from the early stage of the epidemic in China, she noticed that the course of COVID-19 was related to the body mass index (BMI) of patients. Studies in other countries have been similar: obese people are more likely to die from COVID-19 than people of normal weight, even when considering factors such as diabetes and high blood pressure.
There are many reasons why people with a higher BMI have a harder time getting infected. For example, they are more difficult to intubate. They may also have reduced lung capacity. In addition, insulin resistance, which is more common in people with a high BMI, may exacerbate the metabolic effects of coronavirus infection. And the level of the ACE2 receptor (angiotensin converting enzyme2) used by the SARS-CoV-2 virus to access cells is relatively high in adipose tissue.
“Fat appears to act as a reservoir for the virus,” said Gianluca Iacobellis, an endocrinologist at the University of Miami, Florida.
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Additionally, obesity can cause chronic inflammation throughout the body, which contributes to an increased risk of diseases such as type 2 diabetes and heart disease. As a result, people with a higher BMI also have higher levels of immune-regulating proteins, including cytokines.
– The immune response triggered by cytokines can, in some cases, damage COVID-19 damage to healthy tissue – says Milena Sokołowska from the University of Zurich.
Dr. Daniel Drucker, an endocrinologist at Mount Sinai Hospital in Toronto, reminds that SARS-CoV-2 infection lasts for about 5 days longer in obese people than in lean people. This means that obese people have problems with their defense mechanisms against viruses.
Obesity is also associated with a less heterogeneous microbial population in the gut, nose and lungs.
– Microbiota can influence the body’s immune response to pathogens and vaccines, says Sokołowska. Last year, scientists showed that changes in the gut microbiome after taking antibiotics change the response to the flu vaccine.
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Not everyone is convinced that obesity reduces the effectiveness of the COVID-19 vaccine
Dr. Daniel Drucker recalls that research into influenza vaccines has been relatively small in scope and cannot be compared to that of the coronavirus.
In addition, some vaccine shortages can still be compensated. Dr. Donna Ryan believes that one possibility is to give obese people additional doses of the vaccine.
Currently, three vaccines are tested in large clinical trials, and for example, the study conducted by Moderna covers 30. participants. This gives a chance to better assess the effects of vaccines on obese people.
– Much depends on whether volunteers with a high BMI will be included in the tests – says the vaccinologist, Gregory Poland, from the Mayo Clinic in Rochester. “But I won’t be surprised if their antibody levels are lower and won’t last as long as others,” he adds.
“Even a strong response to the vaccine can be confusing,” warns Melinda Beck of the University of North Carolina, researcher on the effects of nutrition on immunity. Obese people initially have normal levels of antibodies after being vaccinated against the flu, but are twice as likely to get the flu than vaccinated lean people, he adds.
Research to date has relied on a definition of obesity based on BMI, an indicator that does not distinguish between fat accumulating under the skin and that accumulating around organs (visceral fat), which is more closely associated with diseases such as diabetes and high blood pressure.
In people of European descent, a BMI of 30 kg / sq m. means obesity. But, for example, people in Asia, the Middle East, and Latin America tend to accumulate visceral fat at a lower BMI.
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Obese people can be vaccinated first
CDC advisers are also considering obese Americans when discussing who should get the coronavirus vaccine immediately. The agency has already identified four groups to be prioritized: healthcare professionals, workers in primary and critical industries, the elderly, and people with comorbidities – including severe obesity. However, it is not known what priority the latter group will receive.
Dr. Barry Popkin, an obesity scientist at the University of North Carolina, analyzed 75 studies about its association with COVID-19. He found that those with a high BMI were 113 percent. more prone to hospitalization, by 74 percent. more obese people went to intensive care units and 48 percent. more often these people died.
Priority is given to vaccinating obese people in the UK. The local public health agency released guidelines last week indicating that people with morbid obesity, that is, with a BMI over 40, should be vaccinated first, even for those under 65 years of age. The same group also includes people with asthma, kidney diseases and a weakened immune system.
No priority is given to obese people who do not reach a BMI threshold above 40. About 28 percent of Britons are considered obese. In the United States, rates are even higher, with 42 percent of Americans reaching the obesity threshold.
See also:
- «Criteria taken from the ceiling». Dr. Paweł Grzesiowski analyzes the National Immunization Program
- SARS-CoV-2 vaccine also for children? 12-year-olds participated in the Pfizer tests
- Places where it is easiest to catch the SARS-CoV-2 cronavirus
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