We have an ongoing pandemic, and yet no one seems to have clear ideas about the virus that triggered it, Covid-19.

First the Italian study that talks about too little or too much testosterone as a risk factor in men , today a new study that talks about obesity as a major risk factor. Let’s go in order and try to understand if the obese are more at risk of contracting the coronavirus, and why.

COVID-19, OBESITY AS A RISK FACTOR?

Dcomedieta.it had already given the news of obesity as a suspected risk factor for Coronavirus, based on data collected by the British app Covid Symptom Tracker by Tim Spector , professor of epidemiology.

Two studies later came out, one in Great Britain and the other in the United States, in which they essentially found a positive association between the number of inpatients, lethality and the obesity factor ( source, source ). Plus another report from ICNARC .

It must be said that these studies are simply observational, so they identify a risk factor but give no further explanations. They limit themselves to highlighting a fact.

In fact, another study, which appeared at the end of April in the journal Nature , says that it is not possible to have a significant association between obesity and Covid-19, because the data are scarce, and above all because, the study cites , there is an obesity paradox. so on the contrary, those who are obese seem more resistant to pulmonary complications from Coronavirus.

Meanwhile, other studies come out.
One in The Lancet speculates that the obesity factor is to be taken into consideration for younger groups , who would therefore be more susceptible to aggravation due to their weight.
Another study comes out on Lombard patients. One on Chinese patients. And yet another on French patients.

So ultimately the studies that starting from hospitalized people identify obesity as a risk factor are numerous, with data coming from different countries. But has anyone provided any possible explanations that clarify the connection?

COVID-19: THE HYPOTHESIS ON OBESITY AS A RISK FACTOR

In an editorial appeared in the journal Obesity Rewievs signed by doctor Radwan Kassir, of the Department of Bariatric Surgery of the CHU Felix Guyon in Réunion, France, the possible explanations that link obesity to an increased risk of adverse events for Coronavirus are listed.

It starts from the fact that obesity in general is a risk factor for many infectious diseases, including influenza. It also increases the risk of thrombosis, and the reason here is quite simple to understand, since the obese have a greater risk of cardiovascular and metabolic syndrome in general.

The doctor’s most interesting (always hypothetical) explanation , however, is an enzymatic one. 
Those who are obese would have more ACE2 thanks to the presence of these enzymes in the cells of the adipose tissue.

ACE2 are essentially type 2 angiotensin converting enzymes, which function as hormones and receptors, which are found on cell membranes and in various organs or tissues, including the intestinal and adipose tissue. They would be the gateway for the Covid 19 virus to enter the body. And this predilection of the Coronavirus for ACE2 as a “gateway” would be more pronounced than in other viruses. By having more ACE2 on cell membranes, an obese person would therefore be more at risk.

Read also: how to get rid of the pounds from Covid.