COVID-19: Previous respiratory disease and obesity as a risk factor
The data of the largest German cohort to date with a total of 50 Covid 19 sufferers from the Heinsberg district were evaluated. All patients suffered from severe courses and were treated in the RWTH Aachen University Hospital. Using this case group, the doctors at the university clinic created the characteristics of severe COVID-19 courses. It is striking that there are an above-average number of overweight people among those affected.
Physicians around Professor Dr. med. Michael Dreher, Director of the Clinic for Pneumology and Internal Intensive Care Medicine at RWTH Aachen University, analyzed a case group of 50 German Covid 19 patients from the Heinsberg district who were treated with severe courses at RWTH Aachen University. The researchers paid particular attention to the difference between courses with or without acute respiratory distress syndrome (ARDS). Obesity seems to be an important factor here. The results were recently presented in the "German Medical Journal".
Who were the patients?
The University Hospital Aachen is located near the severely affected district of Heinsberg. For this reason, in the early phase of the pandemic, many COVID-19 sufferers were treated with severe courses. A group of 50 patients was now evaluated to create a comparative representation of clinical characteristics of severe COVID-19 courses.
In the case group there were 24 infected people who had to be intubated (artificial respiration) and 26 affected people who could still breathe themselves but needed additional oxygen. All those affected in the case group were between 58 and 76 years old. The average age was 65 years.
Characteristics of the course of the disease
The COVID-19 sufferers were admitted to the university hospital on average four days after the onset of symptoms. When analyzing the cases of illness, the doctors tried to identify which factors lead to the fact that those affected develop an acute respiratory distress syndrome and need artificial ventilation. Two characteristics emerged particularly clearly.
Respiratory pre-existing conditions and obesity
On the one hand, those who developed pre-respiratory diseases predominantly developed ARDS. 58 percent of those with ARDS suffered from respiratory diseases in advance. In the group without ARDS, only 42 percent had previous respiratory disease.
The presence of obesity and obesity seems to be more clearly related to the development of acute respiratory distress syndrome. 83 percent of those with ARDS were overweight or obese, whereas only 42 percent in the group without ARDS had an increased body mass index (BMI).
Viral load and death rates were the same in both groups
There was no difference in viral load between the two groups. The amount of viruses present does not seem to be a reliable factor in whether an ARDS develops or not. In the ARDS group, three people died of multiple organ failure. But also in the group without ARDS, four patients died of respiratory failure (lung weakness).
What conclusion does the study suggest?
Although the study does not provide definitive evidence, the data suggest that the risk of ARDS in COVID-19 disease increases if the patient has a pre-existing respiratory disease and / or overweight or obesity. The extent of the viral load seems to play a subordinate role in this context. The University Hospital RWTH Aachen points out that only patients with severe symptoms were examined. Therefore, the results cannot be transferred to mild courses of the infection. (vb)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Graduate editor (FH) Volker Blasek
- University Hospital Aachen: Largest cohort in Germany to date: characteristics of 50 Covid-19 patients at University Hospital RWTH Aachen (published: April 6th, 2020), ukaachen.de
- Dreher, Michael; Kersten, Alexander; Bickenbach, Johannes; u.a .: Characteristics of 50 hospitalized COVID-19 patients with and without ARDS; in: Deutsches Ärzteblatt, 2020, aerzteblatt.de