Obese or overweight coronavirus patients most in need of critical care

Research into the first 196 patients admitted to intensive care units showed most were male, with an average age of 63

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Credit: Peter Byrne/PA

Seven in 10 patients admitted to intensive care units in the UK with coronavirus were overweight or obese, the first data on Britain's cases shows. 

The research - which examined in detail the first 196 patients to receive critical care for the virus - showed the average age of those requiring such care was 63, and seven in 10 cases were male. 

Current UK health policies to prevent the spread and impact of coronavirus have focused in particular on people over the age of 70, especially those who are frail, and those with underlying health conditions. 

International research has suggested these groups will see the highest death rates - of up to 15 per cent in the over-80s.

However, the national audit suggested many cases so far in the UK involved those who were younger, living independently, and without serious health conditions - other than excess weight. See the breakdown below.

The UK research showed seven in 10 cases admitted to critical care units were male, in line with previous studies, which found that the virus was far more deadly in men. These showed that of all suspected cases, 1.7 per cent of women who contract the virus were expected to die compared with 2.8 per cent of men.

The study also confirmed London as the UK epicentre of the outbreak, with more than half of UK cases in critical care units being treated in the capital. 

Experts said Britain’s high levels of obesity could make the virus more deadly, with excess weight linked to a range of health problems, many of which may not have been diagnosed. 

The study by the Intensive Care National Audit and Research Centre shows that 71.7 per cent of those in critical care units were overweight or obese, compared with levels of 64 per cent in the adult population overall. 

But medics said it was also possible that pressures on critical care units already meant that younger patients were more likely to be be prioritised, in the hope of better survival. 

The research found that of the 196 patients admitted to critical care, 16 had died. 

Few of those in the study were found to be suffering from severe underlying health problems - 4 per cent had renal problems, 3.7 per cent were immunocompromised, and 3 per cent had lung conditions. 

However, scientists stressed that many of those who were obese were likely to be suffering from other health conditions, such as diabetes, which might compromise health but were not recorded in the data. 

Dr Rosena Allin-Khan, an A&E doctor and Labour MP for Tooting, south London, said: "Some of the most startling news seems to be that some of the sickest patients that we have had in this department recently have been young. 

"We have patients who are in their 30s and early 40s who were previously fit and well who are now in intensive care and fighting for their lives. This is a virus that is very, very difficult to predict."

International research suggests the virus has a mortality rate of almost 15 per cent among those over the age of 80, 8 per cent for those in their 70s, and 3.6 per cent for those in their 60s. This compares with rates of less than 0.5 per cent in those below the age of 50.

Dr Bharat Pankhania, Senior Clinical Lecturer at the University of Exeter, said that while many of those found in critical care units in the UK were relatively young, they were not fit and healthy. 

He said: "We do know for a fact that a high body mass index does make you more susceptible to quite a few other conditions - heart attack, arthritis - and you could quite easily add to that as well as a coronavirus infection. 

"This is not an illness of just the old people, Proportionally more old people may be affected with severe illness but that doesn't mean young people will get away with this scot free," he said. 

Dr Ron Daniels, a Critical Care Consultant at the Heart of England NHS Foundation Trust in Birmingham, said: "This data does suggest people are younger and fitter than  you might expect to see in ITU patients with coronavirus. That said, we do have an obesity crisis, and people who are obese with have a greater predilection to a range of health problems, which wouldn't be picked up in this research.

"The other possibility here is that this is evidence we are admitting patients to ITU on the basis they have the best chance of survival, which might explain why younger ones are coming through."

At the weekend, NHS watchdogs issued hospitals with guidance urging them to prioritise UK Covid-19 patients not by age but by ranking them against a nine-point "clinical frailty scale"

At one end of the scale, with a score of one, were the "very fit" - people who were "robust, active, energetic and motivated" and who "exercised regularly". At the other end, with a score of nine, were the "terminally ill". 

Those with a score of less than five were considered fit enough to benefit from critical care, subject to consideration of any underlying conditions and the severity of their illness. Those scoring over five would be put through a process where doctors must decide if critical care is "appropriate" before proceeding. But until now, hospitals have been left to take their own decisions about how to prioritise cases for treatment.