Covid-19: high rates of severity and death in elderly and patients with chronic diseases reinforces the importance of re
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LETTER TO EDITOR
Covid‑19: high rates of severity and death in elderly and patients with chronic diseases reinforces the importance of regular physical activity Guilherme F. Speretta1 · Richard Diego Leite2 Received: 21 April 2020 / Accepted: 12 July 2020 © Springer-Verlag Italia S.r.l., part of Springer Nature 2020
Coronavirus disease 2019 (Covid-19) caused by Coronavirus 2 (SARS-CoV-2) has been emerging exponentially worldwide with approximately 8,261,260 confirmed cases and 445,468 deaths up to Jun 17, 2020 [1]. Although in most cases the Covid-19 symptoms are mild, the SARS-CoV-2 is transmitted easily and quickly and can overwhelm health systems [2]. Current evidence indicated that at least 15% of Covid-19 patients develop severe symptoms and need intensive care [3–5]. Noticeably, age is a factor that contributes to severe outcomes [6] and the presence of chronic diseases (CDs), in patients at any age, seems to contribute to severity and death [5]. An Italian report has described the characteristics of Covid-19 associated deaths, showing that the mean age was 78.5 and the most common pre-existing comorbidities were hypertension and diabetes [5]. Furthermore, according to data from the China outbreak, hypertension and diabetes were more prevalent in Covid-19 patients with severe (23.6 and 16.8%, respectively) compared to those with nonsevere (13.3 and 5.7%) symptoms [3]. It is well accepted that increases in visceral adipose tissue lead to metabolic alterations and chronic inflammation, increasing the risk for CDs [7]. These disturbers also negatively impact immunity from infection, vaccine efficacy [8], and may contribute to the severity of Covid-19 since evidence suggests that a subgroup of those patients have a cytokine storm syndrome (i.e. hyperinflammation) [9]. Indeed, it has been demonstrated that obesity is a risk factor * Guilherme F. Speretta [email protected] 1
Department of Physiological Sciences, Biological Sciences Center, Federal University of Santa Catarina (UFSC), Rua Roberto Sampaio Gonzaga s/n, Trindade, Florianópolis, SC 88040‑900, Brazil
Department of Sports, Centre for Physical Education and Sports, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil
2
for Covid-19 intensive care admission in patients younger than 60 years in the United States [10]. A French study also showed that the risk for invasive mechanical ventilation among Covid-19 patients was 7.36 higher for those with body mass index (BMI) > 35 kg/m2 compared to patients with BMI
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