Sir Harry Solomon School of Economics and Management, Western Galilee College, Acre 2412101, Israel.
Institute of Urban and Regional Studies, Hebrew University of Jerusalem, Mt. Scopus, Jerusalem 9190501, Israel.
J Obes. 2022 Jun 20;2022:4320120. doi: 10.1155/2022/4320120. eCollection 2022.
SARS-CoV-2 virus disease (COVID-19) is declared a global pandemic with multiple risk factors. Obesity is considered by several researchers as one of the serious risk factors for SARS-CoV-2 virus complications based on recent empirical studies. Yet, other scholars argue in favor of the existence of an obesity survival paradox and criticize the former group of studies on the grounds that they lack controls for race, socioeconomic status, or quality of care. The objective of the current study is to analyze the potential relationships between different SARS-CoV-2 virus indicators and obesity on a country-wide level based on an OECD report. In an attempt to test the counterintuitive possibility of an obesity survival paradox, the proposed empirical model relaxes the assumption of monotonic change by applying the quadratic design and testing which one of the two competing models (i.e., quadratic or linear) better fits the data. Findings suggest more complex relationships between SARS-CoV-2 virus indices and obesity rates than previously thought. Consequently, ethical guidelines referring to priority in intubation and intensive care treatments-published by the Israeli Ministry of Health in April 2020-should account for these complex relationships between obesity and SARS-CoV-2 virus. Indeed, there is a linear increase in mortality rate from SARS-CoV-2 virus with an elevated prevalence of obesity. Yet, other indicators, such as the number of infected per 10,00,000 persons, rates of severe SARS-CoV-2 virus cases, rates of recovered SARS-CoV-2 virus patients, and SARS-CoV-2 virus, as the cause of death exhibit quadratic, rather than linear, patterns. The reasons for these nonlinear patterns might be explained by several conditions such as increased metabolic reserves, more aggressive treatment, other non-SARS-CoV-2 virus complications for obese persons, and unidentified factors that should be examined in future research.
SARS-CoV-2 病毒病（COVID-19）被宣布为具有多种风险因素的全球大流行。根据最近的实证研究，一些研究人员认为肥胖是 SARS-CoV-2 病毒并发症的严重危险因素之一。然而，其他学者则赞成肥胖生存悖论的存在，并以缺乏对种族、社会经济地位或护理质量的控制为由，批评前一组研究。本研究的目的是根据经合组织的一份报告，在全国范围内分析不同的 SARS-CoV-2 病毒指标与肥胖之间的潜在关系。为了尝试检验肥胖生存悖论的反直觉可能性，所提出的实证模型通过应用二次设计和测试来放松单调变化的假设，从而检验两种竞争模型（即二次或线性）中哪一个更适合数据。研究结果表明，SARS-CoV-2 病毒指标与肥胖率之间的关系比之前想象的更为复杂。因此，以色列卫生部在 2020 年 4 月发布的关于插管和重症监护治疗优先级的伦理准则，应该考虑肥胖和 SARS-CoV-2 病毒之间的这些复杂关系。实际上，肥胖患病率升高与 SARS-CoV-2 病毒的死亡率呈线性增加。然而，其他指标，如每 100 万人感染人数、严重 SARS-CoV-2 病毒病例的比例、SARS-CoV-2 病毒康复患者的比例以及 SARS-CoV-2 病毒作为死亡原因的比例，则呈二次而不是线性模式。这些非线性模式的原因可能可以通过多种条件来解释，例如增加的代谢储备、更积极的治疗、肥胖者的其他非 SARS-CoV-2 病毒并发症以及应在未来研究中检查的未识别因素。
