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Lesson 2a: More responses = more insights on WEIGHT

89 responses received by September 28. Neither a huge nor a tiny number.

 

Our first look at weight change during "long-term" COVID-19, had included 49 respondents by September 18.

 

If you have not read those results they're here: "Lesson 2: So what about that weight gain?"

 

So what's new on those weight scales?  

More incoming data, should add clarity to the results. Let's have a look.

For this articles, I'll show you a clip of the results. For all the responses, and then some subgroups. These are each named at the head of each image that follows.

 

Then each time, I'll try to limit myself to a few succinct phrases to help with interpretaion. If you don't like mine, write yours in a comment below. Or send them to questionnaire@callingcovid.com

 

 

First up, all the results with weight data provided (83 of 86). Recall: before being ill, and about the time the questionnaire was completed.

 

1) Weight data complete - 27 September

 

      1. mostly female respondents (assume mostly females have "long-term" COVID-19).
      2. BMI Before and on Q date almost identical! Recall that these are means. So as long as there are about equal losses and gains of weight, the averages can be quite close.
      3. Proof of that? the ranges go from lost 16.4 Kg to gained 15.9 Kg.
      4. About half (47%) of respondents gained weight. At the bottom of our previous article, was offered an explanation about how this could be. Sick and gaining weight? Unusual. Cholera patients don't do that. Why COVID-19. Read it to get an answer.
      5. Some gain, some lose. That described a "U"-shaped distribution with regard to weight and COVID-19. Do people who gain, have a different disease profile (and outcome) than those who lose weiight? We'll see.

 

----------  number 2 ----------

 

 

2) Age less than 49 - 27 September

 

      1. 43 people, around 38 years old. Still more women than men.
      2. They were overweight to begin with.
      3. More lost weight (some a lot), but just under a third, gained.

 

 

----------  number 3 ----------

 

 

3) Age greater than 49 - 27 September

 

 

      1. 46 people, about 56 years old
      2. Somewhat more women then men
      3. 61% gained weight. That's more than in the group age 49 and less.
      4. Notice also the older group have been sick for 6.64 months, versus 6.2 months. That seems like a small difference. But as the number of responses increase, that may prove to be a significant difference. Is it because they are older? or heavier? or both? I don't know.

 

 

----------  number 4 ----------

 

 

4) Female respondents - 27 September

 

      1. Just the women. 80 of them who present as sick with "long-term" COVID-19.
      2. Age around 48 years. Before getting sick, they were overweight based on BMI of 27.4 Kg/m²
      3. Some lost, some gained (up to 15.9 Kg) with an average gain (includes those who lost and those unchanged), of 0,419 Kg or about 1 lb, on average.
      4. Been sick, an average of 6.4 months.

 

 

----------  number 5 ----------

 

5) Male respondents - 27 September

 

      1. Just the men. (Only) 9 of then. 
      2. Age around 42 years. Is that an actual difference from the women? Well by a thing called Student's t-test (details spared), a p-value of 0.1374 says that it's not significant, but getting close. If you say: "women and men here have different ages, and the women are older." There are 14 chances out of 100 that your thought is false for some yet unexplained reason. Folks in statistics like to place their bets when its 5 chance or less out of 100. It suggests that is in need of follow-up. And if the number of men had been 18, p = 0.0409 (4 chances out of 100 there is actually no difference, when there really is one is one).
      3. Most (44%) LOST weight. On average, 2.7 lbs.
      4. On average, sick slightly longer than the women, on average: 6.8 months.
      5. Without wishing this illness on anyone, it would be nice to have a few more male respondents. Maybe you know one you could ask?

 

 

----------  number 5 ----------

 

Did one's "shape" contribute to winding up being a "long-term" COVID-19 patient?

Here for starters, one assumes that everyone who answered the questionnaire, did so because they believe they have or had this illness.

Let's look at those who sere "skinny" before getting sick.

 

6) Were Underweight Before Illness - 27 September

 

      1. First, (only) 8 were underweight before (BMI < 18.5 Kg/ m²)
      2. They are all women.
      3. Age about like all the others: 44.5 years, on average.
      4. They either lost or gained. No one stayed the same.
      5. Most (38%) gained weight. In fact on average, they moved out of the "Underweight" category, into "Normal, healthy weight." That in itself may not be a reason to say: "Thank goodness for that virus!"
      6. Sick on average 25 weeks when they answered the questionnaire.

 

 

 

----------  number 6 ----------

 

To compare those who began as underweight, how about with another small group?

At the other end of the scales, those who were obese before illness began.

 

3 Classes of obesity

 

 

7) Were Obese Before Illness - 27 September

 

      1. A total number of 21 of 89 (23.6%) respondents were obese before getting sick.
      2. Age about the same as those above, or slightly older at 47,5 years on average.
      3. Mostly females. An average weight of 98.8 Kg before illness began.
      4. Of these obese patients, 9 were Class 1; 8 were Class 2; 4 were Class 3.
      5. Overall, the change from before to now has been a gain of 0.286 Kg, on average. Again because some have lost weight and some have gained, that average seems like a "no big deal" result. Some have lost up to 16.4 and others up to 15.9 Kg. (35 lbs in either direction).
      6. Duration of illness seemed similar to that of other respondents. Or very slightly longer so far.

 

 

----------  number 7 ----------

 

 

8) Were Not Overweight but Became So - 27 September

 

      1. 7 respondents, all female, were not overweight, but became so during their illness.
      2. Age 47 years, and gaining on average: 7.3 Kg (16.2 lbs)
      3. Their duration of illness was slightly longer.

 

 

 

----------  number 8 ----------

 

A very few individuals passed from being overweight to being obese.

 

9) - Were Not obese but bacame so - 27 September

 

 

      1. Only 3 respondents in this group.
      2. 2/3rds women. 1/3rd men.
      3. Apparently ill less long, though few respondents makes this conclusion suspect.
      4. On average, slightly older: 54.7 years.
      5. Weighed on average, 81Kg Kg before with a mean height of 167 cm.

 

 

So what can one conclude?

      1. Change in weight in those with "long-term" COVID-19 seems to be the rule rather than the exception.
      2. Unlike with many serious illnesses, weight gain is a potential outcome, with change in Body Mass Index.
      3. Why does weight gain happen? Of course "round up the usual suspects" is what we tend to do in first approaching this question: reduced activity; increased caloric intake; boredom; thyroid and other hormonal imbalances; depression. You name it.
      4. But an argument can be made that this is, in some respondents summarized here, a part of the infection itself. A viral effect on adipocytes (fat cells), and how fats are perhaps no longer utilized for the same things as before. For instance, getting incorporated into cellular membranes. For instance, actually making more adipocytes. For instance, glucose uptake and utilization that has been significantly altered. These have been referred to in the previous article on weight changes. Look here at the bottom of the page if you missed that.
      5. Of course, number 4 above cannot be drawn as a conclusion from the results presented above. The results presented above still require an explanation. 
      6. But these results so far, prompt at least one additional thought. Based on combining these results with the effect of virus on fat cells alluded to above.
        1. If this effect is in fact present in a person in our repondent group, exercise to combat this weight gain, may not be effective. That doesn't say not to do it. It says that it may not very readily get the desired result.
        2. Same for dieting.
        3. Same for certain supplements and therapies that appear at present more frequently.
        4. Unless a therapy has a specific effect at a cellular level on adipocytes, it may have little effect.
        5. Again, not everyone gained weight. Only just under half of the respondents. It is not limited to one gender. So specific hormonal explanations that are gender specific seem unlikely. That requires pursuit at a different scientific setting, than through this questionnaire.

 

In closiing ...

We do have evidence here of a change from the time before illness in body size. For the group as a whole, given these results, the causes are more than likely multifactorial.

 

But responses to other questions, on topics seemingly unrelated to body weight, were also obtained.

We'll look at how some of these might fit together.

 

For instance: Is there any difference in the diagnostic delay (the time from when a person got sick to when told, "You have COVID-19," that might be different in those of different body sizes, and alterations during the illness?

 

So we'll look at delay of diagnosis and body size.  Typically in Medicine and its disciplines, a delay in diagnosis contributes to undesired outcomes: complications of illness and therapy, length of lospital stay, overall length of illness, costs, and yes, mortality rates.

 

So diagnostic delay in various "sizes" of respondents is coming up.

 

But not now.

 

Now, you've read enough!

 

-----------

 

This was Lesson 2a: "More responses = more insights on WEIGHT"

 

Here are those that came before, also grown from the seeds of these terrific responses, if you missed them:

 

Lesson 1: Test results - how uncertainty changes our lives

 

Lesson 1a: Test results - adding light as well as heat.

 

Lesson 2: So what about that weight gain?

 

Lesson 3: Effective emotional support - where shall we turn?

 

Lesson 4: "Long-term" COVID-19 - How scary is that?

 

Lesson 5: Fostering Resilience

 

 

I'll work a deal with you.

  • If you do a little work to keep those responses coming from those with "long-term" COVID-19,
  • I'll do a little work, analyze responses, and feed them back towards those who might benefit.

 

Have we got a Deal?

 

 

 

<<<<<<<<< Introduction to the Questionnaire

 

 

 

 

 

 



28/09/2020
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