肥胖(體重過重)也是造成新冠肺炎急速惡化的因子

今天看到死亡個案出現一個「無慢性病史」的30幾歲女性，怎麼會這樣呢？

沒多久就就看到這個報導，

30多歲女「快速死」PCR陰轉陽5天不治 體重90公斤致病情惡化

「肥胖症」其實早就被世界衛生組織正名是一種「脂肪相關慢性疾病」（Adiposity-Based Chronic Disease (ABCD) )積極治療肥胖根本不是外觀的問題，而是跟治療高血壓、糖尿病一樣，刻不容緩的事情。

在今年四月前新冠死亡率居全球之冠的捷克，每10萬人就有229人染疫喪命，而捷克的肥胖是全歐洲之冠，女性57%肥胖、男性71%肥胖，10個新冠患者有8個肥胖， 新冠死亡率被認為跟肥胖有明確且嚴重的相關性。

台灣目前是亞洲的肥胖冠軍........

一些區域的研究，發現糖尿病會讓新冠病毒死亡的風險多了8倍，而肥胖可以讓死亡風險高達10倍。

如果控制血糖跟血壓很重要，那控制體重難道不是更重要嗎？

研究證實，當肥胖者減少5%以上體重(如成人90公斤，減少5公斤)，就可以為健康帶來許多益處，高血壓、糖尿病等與肥胖相關疾病將可改善。

強烈建議以後新冠肺炎死亡病例的「慢性病史」，麻煩一定要把「肥胖」列入在裡面，才能讓民眾正視自己的健康問題！
​
對於醫療人員來說處理肥胖，也是非常緊急的事，當BMI超過25時，每增加1單位，相對所有原因死亡率風險便增加9％，包括心因性猝死風險，是的，先不提快樂缺氧了，每個BMI在30以上的人，我都會嚴正告訴他猝死的風險，千萬不要因為自己年輕、或是血液報告尚可，就忽視了隱藏的風險。

​也可以參考美國疾病管制局
www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

​OverviewAdults of any age with the following conditions can be more likely to get severely ill from COVID-19. Severe illness means that a person with COVID-19 may need:

• Hospitalization
• Intensive care
• A ventilator to help them breathe
• Or they may even die

In addition:

• Older adults are more likely to get severely ill from COVID-19. More than 80% of COVID-19 deaths occur in people over age 65, and more than 95% of COVID-19 deaths occur in people older than 45.
• Long-standing systemic health and social inequities have put various groups of people at increased risk of getting sick and dying from COVID-19, including many racial and ethnic minority groups and people with disabilities.
  • Studies have shown people from racial and ethnic minority groups are also dying from COVID-19 at younger ages. People in minority groups are often younger when they develop chronic medical conditions and may be more likely to have more than one condition.
  • People with disabilities are more likely than those without disabilities to have chronic health conditions, live in congregate setting, and face more barriers to healthcare. Studies have shown that some people with certain disabilities are more likely to get COVID-19 and have worse outcomes.

If you have a medical condition, speak with your healthcare provider about steps you can take to manage your health and risks.  
Preventive measures for COVID-19 (including vaccination, wearing a mask and social distancing) are important especially if you are older or have multiple or severe health conditions. You can learn about CDC’s COVID-19 vaccine recommendations, including how medical conditions and other factors inform recommendations, here.
Note: The list below does not include all potential medical conditions that could make you more likely to get severely ill. Rare medical conditions may not be included below. However, a person with a condition that is not listed may still be in more danger from COVID-19 than persons of similar age who do not have the condition and should talk with their healthcare provider.
Top of PageMedical Conditions in Adults

• This list is presented in alphabetical order and not in order of risk.
• CDC completed an evidence review process for each medical condition on this list to ensure they met criteria for inclusion on this webpage.
• We are learning more about COVID-19 every day, and this list may be updated as the science evolves.

CancerHaving cancer can make you more likely to get severely ill from COVID-19. Treatments for many types of cancer can weaken your body’s ability to fight off disease.  At this time, based on available studies, having a history of cancer may increase your risk.
Get more information:

• Cancer | CDC
• American Cancer Society: What People with Cancer Should Know about Coronavirusexternal icon

Chronic kidney diseaseHaving chronic kidney disease of any stage can make you more likely to get severely ill from COVID-19.
Get more information:

• Chronic kidney disease | CDC
• National Kidney Foundation: Kidney disease and COVID-19external icon

Chronic lung diseases, including COPD (chronic obstructive pulmonary disease), asthma (moderate-to-severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertensionChronic lung diseases can make you more likely to get severely ill from COVID-19. These diseases may include:

• Asthma, if it’s moderate to severe
• Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
• Having damaged or scarred lung tissue such as interstitial lung disease (including idiopathic pulmonary fibrosis)
• Cystic fibrosis, with or without lung or other solid organ transplant
• Pulmonary hypertension (high blood pressure in the lungs)

Get more information:

• COPD | CDC
• Asthma | CDC
• American Lung Association: Controlling Chronic Lung Diseases Amid COVID-19 external icon
• Cystic Fibrosis | CDC

Dementia or other neurological conditionsHaving neurological conditions, such as dementia, can make you more likely to get severely ill from COVID-19.
Get more information:

• Dementia | CDC
• Alzheimer’s Association: COVID-19, Alzheimer’s and Dementia external icon

Diabetes (type 1 or type 2)Having either type 1 or type 2 diabetes can make you more likely to get severely ill from COVID-19.
Get more information:

• Diabetes | CDC
• American Diabetes Association: How COVID-19 Impacts People with Diabetesexternal icon

Down syndromeHaving Down syndrome can make you more likely to get severely ill from COVID-19.
Get more information:

• Down syndrome | CDC
• National Down Syndrome Society: COVID-19 and Down Syndromeexternal icon

Heart conditions (such as heart failure, coronary artery disease, cardiomyopathies or hypertension)Having heart conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension) can make you more likely to get severely ill from COVID-19.
Get more information:

• Heart Disease | CDC
• COVID-19 | American Heart Associationexternal icon

HIV infectionHaving HIV (Human Immunodeficiency Virus) can make you more likely to get severely ill from COVID-19.
Get more information:

• HIV Infection | CDC
• Interim Guidance for COVID-19 and Persons with HIVexternal icon

Immunocompromised state (weakened immune system)Having a weakened immune system can make you more likely to get severely ill from COVID-19. Many conditions and treatments can cause a person to be immunocompromised or have a weakened immune system. Primary immunodeficiency is caused by genetic defects that can be inherited. Prolonged use of corticosteroids or other immune weakening medicines can lead to secondary or acquired immunodeficiency.
Get more information:

• Types of Primary Immune Deficiency Diseasesexternal icon
• The Jeffrey Modell Foundationexternal icon
• Immune Deficiency Foundationexternal icon
• Primary Immunodeficiency (PI) | CDC

Liver diseaseHaving chronic liver disease, such as alcohol-related liver disease, nonalcoholic fatty liver disease, and especially cirrhosis, or scarring of the liver, can make you more likely to get severely ill from COVID-19.
Get more information:

• Liver Disease | NIDDK (nih.gov)external icon
• American Liver Foundation: Your Liver & COVID-19external icon

Overweight and obesityOverweight (defined as a body mass index (BMI) > 25 kg/m2 but < 30 kg/m2), obesity (BMI ≥30 kg/m2 but < 40 kg/m2), or severe obesity (BMI of ≥40 kg/m2), can make you more likely to get severely ill from COVID-19.  The risk of severe COVID-19 illness increases sharply with elevated BMI.
Get more information:

• Obesity | CDC
• Obesity, Race/Ethnicity, and COVID-19 | CDC
• Obesity Action Coalition: COVID-19 and Obesityexternal icon

PregnancyPregnant and recently pregnant people (for at least 42 days following end of pregnancy) are more likely to get severely ill from COVID-19 compared with non-pregnant people.
Get more information:

• Pregnant and Recently Pregnant People | CDC
• Toolkit for Pregnant People and New Parents | CDC
• Investigating the Impact of COVID-19 during Pregnancy | CDC

Sickle cell disease or thalassemiaHaving hemoglobin blood disorders like sickle cell disease (SCD) or thalassemia can make you more likely to get severely ill from COVID-19.
Get more information:

• Sickle Cell Disease | CDC
• Thalassemia | CDC

Smoking, current or formerBeing a current or former cigarette smoker can make you more likely to get severely ill from COVID-19. If you currently smoke, quit. If you used to smoke, don’t start again. If you’ve never smoked, don’t start.
Get more information:

• Smoking & Tobacco Use | CDC
• How to Quit Smoking | Quit Smoking | Tips From Former Smokers | CDC
• Health Benefits of Quitting Smoking | CDC

Solid organ or blood stem cell transplantHaving had a solid organ or blood stem cell transplant, which includes bone marrow transplants, can make you more likely to get severely ill from COVID-19.
Get more information:

• Transplant Safety | CDC
• COVID-19 Resources for Transplant Communityexternal icon

Stroke or cerebrovascular disease, which affects blood flow to the brainHaving cerebrovascular disease, such as having a stroke, can make you more likely to get severely ill from COVID-19.
Get more information:

• Stroke | CDC
• COVID19 Stroke Podcast Series for Patients and Caregivers external icon

Substance use disordersHaving a substance use disorder (such as alcohol, opioid, or cocaine use disorder) can make you more likely to get severely ill from COVID-19.
Get more information:

• How to Recognize a Substance Use Disorderexternal icon
• Learn more about people who use drugs or have Substance Use Disorder and COVID-19 | CDC
• Drug Overdose

Information on Children and TeensWhile children have been less affected by COVID-19 compared with adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Current evidence suggests that children with medical complexity, with genetic, neurologic, metabolic conditions, or with congenital heart disease can be at increased risk for severe illness from COVID-19. Similar to adults, children with obesity, diabetes, asthma or chronic lung disease, sickle cell disease, or immunosuppression can also be at increased risk for severe illness from COVID-19. One way to protect the health of children is to ensure that all adults in a household are fully vaccinated against COVID-19.

• Children, Teens, and Young Adults | CDC
• COVID-19 Parental Resources Kit | CDC

Actions You Can TakeIn general, the older you are, the more health conditions you have, and the more severe the conditions, the more important it is to take preventive measures for COVID-19 such as vaccination, wearing a mask , social distancing, and practicing hand hygiene. Please contact your state, tribal, local, or territorial health department for more information on COVID-19 vaccination in your area.
It is important for people with medical conditions and their providers to work together and manage those conditions carefully and safely. Get a COVID-19 vaccine as soon as you can. If you have a medical condition, the following are actions you can take based on your medical conditions and other risk factors:

• Continue your medicines and do not change your treatment plan without talking to your healthcare provider.
• Follow your current treatment plan (e.g., Asthma Action Plan, dialysis schedule, blood sugar testing, nutrition and exercise recommendations) to keep your medical condition under control.
• Have at least a 30-day supply of prescription and non-prescription medicines. Talk to a healthcare provider, insurer, and pharmacist about getting an extra supply (i.e., more than 30 days) of prescription medicines, if possible, to reduce your trips to the pharmacy.
• Have shelf-stable food choices available to accommodate dietary needs based on your medical condition (e.g., kidney diet and KCER 3-Day Emergency Diet Planexternal icon, diabetic diet).
• Know the triggers for your condition and avoid when possible (e.g., avoid asthma triggers by having another member of your household clean and disinfect your house for you or avoid possible sickle cell disease triggers to prevent vaso-occlusive episodes or pain crises).
• Learn about stress and coping. You may feel increased stress during this pandemic. Fear and anxiety can be overwhelming and cause strong emotions.
• Do not delay getting emergency care for your medical condition because of COVID-19. Emergency departments have infection prevention plans to protect you from getting COVID-19 if you need care.
• Call your healthcare provider if you have any concerns about your medical conditions or if you get sick and think that you may have COVID-19. If you need emergency help, call 911 right away.
• When possible, keep preventive care and other routine healthcare appointments (such as vaccinations and blood pressure checks) with your provider. Check with your provider about safety precautions for office visits and ask about telemedicine or remote healthcare visit options.