UK government scientists are urgently investigating whether people living with obesity may be disproportionately affected by the coronavirus, after emerging data from intensive care units suggested a stronger link than previously thought, BuzzFeed News can reveal.
Senior ministers have privately raised fears that Britain’s obesity rate, which is higher than most other developed countries, could be a factor in its comparatively higher death toll.
Current NHS advice states that people who are very obese — with a body mass index (BMI) of 40 or above — “may be at high risk” from COVID-19, but they are not in the “very high risk” category that requires “shielding” at home at all times.
Government experts on the Scientific Advisory Group for Emergencies (SAGE) are studying whether obesity and severe obesity may lead to worse outcomes for patients than anticipated, multiple sources familiar with the group’s work said.
New data from the UK’s Intensive Care National Audit and Research Centre, which has been presented to ministers and SAGE scientists, has found that the proportion of severely obese patients in ICUs is twice the proportion of severely obese people in the general population.
The Department of Health and Public Health England confirmed to BuzzFeed News that the UK was conducting research on whether there was a causal link between obesity and COVID-19, or whether other comorbidities often found in severely obese people are resulting in increased mortality.
Data and studies from the UK, the US, China, and other European nations have shown there is a strong association between obesity and the coronavirus, sources familiar with the British government’s scientists thinking said, but they warned that it was too early to say if there was a causal link with obesity itself, or a correlation that could be explained by other co-morbidities.
The scientists have cautioned that more research is needed before any definitive conclusions can be established. Discussions have taken place between British scientists and the World Health Organisation about cooperating on further research on possible interactions between obesity and COVID-19, BuzzFeed News has been told.
Ministers have become increasingly alarmed by data coming out of Britain’s intensive care units, with some members of the government suggesting obesity may end up being a factor in the UK’s higher death toll.
The UK is currently projected to have the highest number of coronavirus deaths in Europe, amid criticism of the government over whether it was too slow to enforce social distancing and lockdown measures.
Around 1 in 4 UK adults are obese. In 2018, the WHO found that the UK had the third-highest obesity rate in Europe, behind only Malta and Turkey.
The new data from the UK’s Intensive Care National Audit and Research Centre (ICNARC) showed that the proportion of severely obese ICU patients with the virus was more than double the proportion of severely obese people among the general population.
In a sample of ICU patients studied in England, Wales, and Northern Ireland, 7% had a BMI of over 40. Around 3% of the general population in England is severely obese.
Severely obese people in ICUs were 5 percentage points more likely to die than patients with a healthy weight, the ICNARC data showed.
The findings were starker when it came to the treatment required for severely obese patients compared to patients with a healthy weight.
Of those requiring advanced respiratory treatment, 39% were obese, compared to 25% who had a healthy weight. Of those needing basic respiratory support, 37% were obese. Again, 25% had a healthy weight.
Further studies in the UK, New York, and China have also suggested an association between obesity and the coronavirus, and are being looked at by British ministers and experts.
A study by the Coronavirus Clinical Characterisation Consortium of people hospitalised with the virus in Britain found that the risk of death was 37% higher in obese patients.
Another study in New York found that severely obese people were six times more likely to be hospitalised with COVID-19. Obese people were four times more likely.
A study in China found that people with obesity could be three times more likely to develop severe pneumonia.
According to a report published by the Italian National Institute of Health, a study on a small sample of COVID-19 patients found that obesity was an underlying condition in some of those under the age of 50 who died, but the report doesn't draw any conclusions either way.
SAGE scientists are exploring potential “mechanisms” that could show a causal relationship between obesity and having more severe symptoms of COVID-19, including the potential for the increased inflammatory response in obese people to exacerbate symptoms of the virus.
Sources familiar with SAGE’s work stressed to BuzzFeed News that there was currently not sufficient evidence to prove that obesity itself resulted in increased mortality, and that more research needed to be done. They said that severely obese people are often likely to have other comorbidities that could be responsible for any worse symptoms.
Older people, men, black and Asian people, and those from socially deprived backgrounds were also seeing worse outcomes, the ICNARC data showed.