CMAAO CORONA FACTS and MYTH COVID:  Obesity and Virology

With input from Dr Monica Vasudev

India

healthysoch

New Delhi, September 04, 2020 :

Patients with COVID-19 and obesity BMI] > 30 kg/m² have a higher viral load and the virus seems to persist for longer

Those with a BMI < 25 kg/m² and COVID-19 took approximately 14 days to fully recover, those with BMI 25-30 kg/m² took around 17 days, and those with a BMI > 30 kg/m² took around 19-20 days.

Dror Dicker, MD, from Hasharon Hospital, Petah Tikva, Israel, briefly presented preliminary results of his work at the opening plenary of this year’s virtual European and International Congress on Obesity (ECOICO) 2020.

Addressing whether patients with obesity are more contagious than those without, the research shows individuals with a BMI > 30 kg/m² had COVID-19 statuses that became negative 5 days later than those with a BMI < 25 kg/m², which is considered a healthy weight.

Obese patients have a higher viral load. In adipose tissue the ACE2 levels are higher.

85% of a Seattle fishing boat crew were infected onboard with COVID-19 in May.

 The entire crew had tested negative for infection and had blood drawn before departure.

Upon return, the three people who had neutralizing antibodies before departure were not infected on the ship.

• How long are COVID-19 antibodies protective? It depends on the titers, or the concentration of antibodies, in an individual’s blood.
• People with more severe COVID-19 infection probably have more antibodies, which could possibly protect them from reinfection for a year or more. Milder infections lead to fewer antibodies and could possibly provide protection for up to 6 months.
• 10% of people don’t really show a very strong immune response at all in mild infection. Those people would be at a much higher risk for reinfection. Typically, those reinfections are milder and the people are usually asymptomatic.
• There’s some memory response that gets jolted, and there’s also some antibody and some T cells. So, that’s all good news.

• Virus is always mutating. It throws down two mutations a month. COVID-19 has only been around for 10 months in people. Influenza, RSV, other respiratory viruses, and they’ve been circulating in people for hundreds of years or in different animal hosts that can infect people.
• Across the whole antibody and clinical lab spectrum, you have two different antigens. You have the nucleocapsid, which wraps the genome, and you have the spike protein, which is what binds the cells.
• Most of the tests that are done in the United States are done against the nucleocapsid, because it’s the most sensitive assay and it’s better at telling you whether you were infected.
• What we want are antibody tests that show that spike, the outside glycoprotein from the virus that’s involved in attachment and entry. If you can get antibodies against that, you can say more about what can prevent infection.
• But that’s not what current labs typically are doing. The market is 75%-80% nucleocapsid, 20% spike.
• For the receptor-binding domain, you want to look at the outside of the spike, the part that binds the receptor.

Author: Dr K Aggarwal, President CMAAO