3 ms·

This method suggests a possible mechanism for poorer outcomes in the obese, but that does not mean that the mechanism is correct. The mechanism also involves a

This method suggests a possible mechanism for poorer outcomes in the obese, but that does not mean that the mechanism is correct. The mechanism also involves a way for SARS-CoV-2 to infect lymphocytes in fat tissue that doesn't involve ACE2, which the authors leave completely unexplained, which is whole lot of highly surprising results. There's also simpler explanations for why the obese are at higher risk, because systemically they're in poorer shape to begin with (metabolic syndrome, etc), and mechanically they have more trouble breathing when they get sick. The title explanation is so simplistically attractive while the biological mechanism is unexpected and unexplained, which I'd say adds up to requiring a large amount of skepticism, until it gets validated by real experts in the field (not just someone with an MD or PhD on twitter, but someone who is active in exactly this kind of research). It might be an emotionally satisfying result, but it smells like bad science to me.

andy_ppp 5y ago
I agree with your analysis you are correct to put these ideas forward, it does not mean the paper is incorrect. I personally think we should think of this paper as really useful datapoint rather than a set in stone conclusion either way. For me it's really interesting rather than to be dismissed as being completely not probable. Let's see and wait for other research, but I think it's a great theory that needs a lot for it to be fact (as close as we have to one). What is a fact (again, as close as we can get to one...) is that obese people die a lot more readily from COVID and anyone over say 30 BMI (because of fat) should undoubtedly assess the risk of any vaccine as being massively in their favour!
- lamontcg 5y ago
  Hard disagree. There's so much junk science that articles need to be treated skeptically, particularly if they have strong headline claims that reinforce some common belief combined with details which are hazy and unexplained. Being totally open minded is actually not a virtue, you can be so open minded that you'll start to believe any sort of drivel you pour into your head because it sounds persuasive rather than being correct. I will happily flip my impression of this paper on a dime if someone who is actually qualified to review the actual lab methods and procedures (and if adequate controls were used, etc) pops up to defend it and to explain how cells that don't express ACE2 could possibly be important in COVID-19 pathogenesis, but until then my default setting is to be critical since the paper "smells" bad. It is not a particularly "great" theory, its a very fishy smelling theory.
  - andy_ppp 5y ago
    Are you qualified to judge either way?
    - lamontcg 5y ago
      What are your qualifications for being able to judge this as a "great theory"? You seem to think that you're free to think very highly of this paper on zero experience because the headline is appealing, while someone critical of the paper needs to be an expert.
Villeinesse 5y ago
These researchers (with their 3 dead subjects) completely leave out the critical pro-inflammatory & pro-Covid effects of the nearly universal D-deficiency in all obese, versus we very few who have lucked out with better information or doctors. Since D is completely fat-soluble, the huge fat-masses we obese carry around absorb all the D we normally get, leaving us at highest Covid (& everything else) risk. Still, most of our fat cells are left unfilled and unprotected by immune hormone D! (Our blood levels are insanely low, too, unless intensely supplemented, filling the fat first and only then spilling into our bloodstream where it can do its work.) Only after 20 years of a D-depleting anti-seizure carbamazepine/(Tegretol™) Rx let me double in size and drop to a very dangerous 8ng/ml, was I finally diagnosed & supplemented, though I later discovered 5,000IU/day was far too low for my obesity, raised it to 15,000! (Others can start getting obese after D drops from a simple No-UVB Winter, or standard, insufficiently-supplemented pregnancy.) I now have a super-Replete level about 70ng/ml (my ultimate goal.) I am amazingly cured of my 2-decade severe depression, arthritis, back-pain, pre-diabetes, and my peripheral neuropathy is almost gone, too. Also, no colds or flu's in 4 years. And obviously, every one of my fat cells is fully protected, (along with my blood vessels, heart, lungs & brain) chock-full of D! This is completely unlike those tragically less fortunately informed (who's fat cells were still largely empty of D), and therefore defenseless subjects! They died only because their low D allowed Covid to waltz right in to those very fat cells making them so deeply deficient, and wreak its deadly havock. I luckily caught Covid after I had reached just 54ng/ml. I had no symptoms at all, except a single day of mild sore throat & mild anosmia. At 8ng, Covid could easily have killed me, likely by the mechanisms described in this incomplete study! Yes, I was pre-diabetic, ↑BP & BMI=44 when I flew through my barely noticeable infection, but REPLETE D>50ng/(125nmol) easily protected me as well as any either healthy or CovidComorbid person. It's the low D levels, not the poor condition that let's Covid seriously sicken or kill us! ALL CovidComorbidities are simply conditions of low D! Now, relieved of depression & pain, I've finally found hope & motivation to do the over-a-year Keto & Intermittent Fasting lifestyle to return to my pre-carbamazepine healthy body size, if not the supreme competitive fitness I previously enjoyed. I've already lost 45 pounds, only 80 more to go!

andy_ppp 5y ago

I agree with your analysis you are correct to put these ideas forward, it does not mean the paper is incorrect. I personally think we should think of this paper as really useful datapoint rather than a set in stone conclusion either way. For me it's really interesting rather than to be dismissed as being completely not probable. Let's see and wait for other research, but I think it's a great theory that needs a lot for it to be fact (as close as we have to one). What is a fact (again, as close as we can get to one...) is that obese people die a lot more readily from COVID and anyone over say 30 BMI (because of fat) should undoubtedly assess the risk of any vaccine as being massively in their favour!

lamontcg 5y ago
Hard disagree. There's so much junk science that articles need to be treated skeptically, particularly if they have strong headline claims that reinforce some common belief combined with details which are hazy and unexplained. Being totally open minded is actually not a virtue, you can be so open minded that you'll start to believe any sort of drivel you pour into your head because it sounds persuasive rather than being correct. I will happily flip my impression of this paper on a dime if someone who is actually qualified to review the actual lab methods and procedures (and if adequate controls were used, etc) pops up to defend it and to explain how cells that don't express ACE2 could possibly be important in COVID-19 pathogenesis, but until then my default setting is to be critical since the paper "smells" bad. It is not a particularly "great" theory, its a very fishy smelling theory.
- andy_ppp 5y ago
  Are you qualified to judge either way?
  - lamontcg 5y ago
    What are your qualifications for being able to judge this as a "great theory"? You seem to think that you're free to think very highly of this paper on zero experience because the headline is appealing, while someone critical of the paper needs to be an expert.

Villeinesse 5y ago

These researchers (with their 3 dead subjects) completely leave out the critical pro-inflammatory & pro-Covid effects of the nearly universal D-deficiency in all obese, versus we very few who have lucked out with better information or doctors. Since D is completely fat-soluble, the huge fat-masses we obese carry around absorb all the D we normally get, leaving us at highest Covid (& everything else) risk. Still, most of our fat cells are left unfilled and unprotected by immune hormone D! (Our blood levels are insanely low, too, unless intensely supplemented, filling the fat first and only then spilling into our bloodstream where it can do its work.) Only after 20 years of a D-depleting anti-seizure carbamazepine/(Tegretol™) Rx let me double in size and drop to a very dangerous 8ng/ml, was I finally diagnosed & supplemented, though I later discovered 5,000IU/day was far too low for my obesity, raised it to 15,000! (Others can start getting obese after D drops from a simple No-UVB Winter, or standard, insufficiently-supplemented pregnancy.) I now have a super-Replete level about 70ng/ml (my ultimate goal.) I am amazingly cured of my 2-decade severe depression, arthritis, back-pain, pre-diabetes, and my peripheral neuropathy is almost gone, too. Also, no colds or flu's in 4 years. And obviously, every one of my fat cells is fully protected, (along with my blood vessels, heart, lungs & brain) chock-full of D! This is completely unlike those tragically less fortunately informed (who's fat cells were still largely empty of D), and therefore defenseless subjects! They died only because their low D allowed Covid to waltz right in to those very fat cells making them so deeply deficient, and wreak its deadly havock. I luckily caught Covid after I had reached just 54ng/ml. I had no symptoms at all, except a single day of mild sore throat & mild anosmia. At 8ng, Covid could easily have killed me, likely by the mechanisms described in this incomplete study! Yes, I was pre-diabetic, ↑BP & BMI=44 when I flew through my barely noticeable infection, but REPLETE D>50ng/(125nmol) easily protected me as well as any either healthy or CovidComorbid person. It's the low D levels, not the poor condition that let's Covid seriously sicken or kill us! ALL CovidComorbidities are simply conditions of low D! Now, relieved of depression & pain, I've finally found hope & motivation to do the over-a-year Keto & Intermittent Fasting lifestyle to return to my pre-carbamazepine healthy body size, if not the supreme competitive fitness I previously enjoyed. I've already lost 45 pounds, only 80 more to go!