A new study by researchers at Tufts University, published in the Journal of the American Heart Association (JAHA), reports that nearly 70 percent of adult Coronavirus Disease 2019 (COVID-19) hospitalizations in the United States can be attributed to four cardiometabolic conditions. Out of the hospitalizations, 30.2 percent were attributed to obesity, 26.2 percent to hypertension, 20.5 percent to diabetes, and 11.7 percent to heart failure. In total, 63.5 percent, or 575,419 “of COVID‐19 hospitalizations were attributable to these 4 conditions.”
The researchers analyzed over 900,000 hospitalizations that occurred between the start of the pandemic and November 18, 2020. They used mathematical simulations to estimate the number of COVID-19 hospitalizations that could have been avoided with better control of cardiometabolic health.
When considering “cardiometabolic conditions individually,” a 10 percent reduction in total obesity nationally was estimated to potentially prevent 3.9 percent of COVID-19 hospitalizations. Similarly, a 10 percent reduction in hypertension, diabetes, and heart failure were estimated to potentially prevent 3.5 percent, 2.7 percent, and 1.4 percent of COVID-19 hospitalizations, respectively.
“We know that changes in diet quality alone, even without weight loss, rapidly improve metabolic health within just six to eight weeks. It’s crucial to test such lifestyle approaches for reducing severe COVID-19 infections, both for this pandemic and future pandemics likely to come,” Dariush Mozaffarian, a senior author and dean of the Friedman School, said in a statement.
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Mozaffarian hopes to spread awareness about the importance of practicing healthy lifestyle habits such as regularly exercising, eating nutritious meals, and using strategies to manage stress. Unfortunately, these key preventative health strategies that can be applied to strengthen natural immunity have been lost in recent months among frequent reminders to use masks, socially distance, and receive experimental vaccines.
Hospitalization disparities by race, age, and sex
The authors stated that at “any age group, the proportion of COVID‐19 hospitalizations attributable to each cardiometabolic condition was higher in Black compared with White adults.” When considering the four cardiometabolic conditions together, “the proportion of attributable COVID‐19 hospitalizations was highest in Black adults across all age groups followed by Hispanic, White, and Asian/other adults.”
The proportion of hospitalizations attributed to cardiometabolic risk factors tended to increase with age. For example, while diabetes accounted for only 7.8 percent of hospitalizations in adults aged 18 to 49, the proportion increased to 28.9 percent of hospitalizations in those aged 65 years and older. Similar differences were found between the younger and older age groups for heart failure, with 2.4 percent versus 20.9 percent, and hypertension, with 10.2 percent versus 34.8 percent.
In contrast, the difference was not significant for obesity with a body mass index (BMI) between 30 and 40, with 20.0 percent versus 21.4 percent. The proportion attributed to severe obesity was actually higher in the youngest age groups, with 13.5 percent versus 9.3 percent. Sex differences were “modest,” with the “largest differences in attributable risk for severe obesity,” which were estimated to be 9.2% of COVID‐19 hospitalizations in men versus 13.8% in women.”
Inflated COVID-19 deaths in peer-reviewed study
A report published last October in the Journal of Science, Public Health Policy and Law detailed how the Centers for Disease Control and Prevention (CDC) changed the way the U.S. government counts COVID-19 deaths on March 24, 2020, which “has had a significant impact on data collection accuracy and integrity. It has resulted in the potential false inflation of COVID-19 fatality data and is a potential breach of federal laws governing information quality.”
With regard to filling out death certificates, the authors explain that under the “2003 guidelines, the highest COVID-19 could be listed in the presence of an established comorbidity would be on the lowest used line at the bottom of Part I as an initiating factor or, more correctly, in Part II as an infection that contributed to death. However, on March 24, 2020 the CDC elected to forgo this trusted method of cause of death recording in favor of recording comorbidities in Part 2, so COVID-19 could be listed exclusively in Part 1.”
The study states that federal agencies are mandated to submit “notification for data collection, publication, or analysis” to the Federal Register prior to getting approval from the U.S. Office of Management and Budget’s Office of Information and Regulatory Affairs (OMB/OIRA). These steps ensure compliance with the Paperwork Reduction Act (PRA) and the Information Quality Act (IQA).
The CDC bypassed oversight of the OMB Director’s Information Resources Management “policies, plans, rules, regulations, procedures, and guidelines for public comment” by employing a non-governmental organization called the Council of State and Territorial Epidemiologists (CSTE). The CDC adopted CSTE’s position paper to establish rules for COVID-19 diagnosis.
“We allege this is a violation of 44 U.S. Code 3517(a), which requires an agency to provide interested persons an ‘early and meaningful opportunity to comment’,” states the report. “This violation has inevitably resulted in COVID-19 data for cases, hospitalizations, and fatalities being artificially elevated, and definitively compromises prudent decision making at federal and state executive levels.”
The authors of the study compared the COVID-19 death toll under the new CDC counting system with that of the old system that has been “used successfully for 17 years without need of update.” Through Aug. 23, 2020, 161,392 COVID-19 deaths were reported using the new CDC guidelines versus only 9,684 using the 2003 guidelines. In other words, the reported number of fatalities would have been 16.7 times lower using the old system.
Arvind Datta contributed to this report.