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Understanding the Co-Epidemic of Obesity and COVID-19: Current Evidence, Comparison with Previous Epidemics, Mechanisms, and Preventive and Therapeutic Perspectives
- Source :
- Current Obesity Reports
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Purpose of Review A growing body of evidence suggests that obesity and increased visceral adiposity are strongly and independently linked to adverse outcomes and death due to COVID-19. This review summarizes current epidemiologic data, highlights pathogenetic mechanisms on the association between excess body weight and COVID-19, compares data from previous pandemics, discusses why COVID-19 challenges the “obesity paradox,” and presents implications in prevention and treatment as well as future perspectives. Recent Findings Data from meta-analyses based on recent observational studies have indicated that obesity increases the risks of infection from SARS-CoV-2, severe infection and hospitalization, admission to the ICU and need of invasive mechanical ventilation (IMV), and the risk of mortality, particularly in severe obesity. The risks of IMV and mortality associated with obesity are accentuated in younger individuals (age ≤ 50 years old). The meta-inflammation in obesity intersects with and exacerbates underlying pathogenetic mechanisms in COVID-19 through the following mechanisms and factors: (i) impaired innate and adaptive immune responses; (ii) chronic inflammation and oxidative stress; (iii) endothelial dysfunction, hypercoagulability, and aberrant activation of the complement; (iv) overactivation of the renin–angiotensin–aldosterone system; (v) overexpression of the angiotensin-converting enzyme 2 receptor in the adipose tissue; (vi) associated cardiometabolic comorbidities; (vii) vitamin D deficiency; (viii) gut dysbiosis; and (ix) mechanical and psychological issues. Summary Mechanistic and large epidemiologic studies using big data sources with omics data exploring genetic determinants of risk and disease severity as well as large randomized controlled trials (RCTs) are necessary to shed light on the pathways connecting chronic subclinical inflammation/meta-inflammation with adverse COVID-19 outcomes and establish the ideal preventive and therapeutic approaches for patients with obesity.
- Subjects :
- 0301 basic medicine
030209 endocrinology & metabolism
Inflammation
Comorbidity
Cytokine storm
Bioinformatics
Severity of Illness Index
Body Mass Index
law.invention
03 medical and health sciences
Influenza A Virus, H1N1 Subtype
0302 clinical medicine
Immune system
Randomized controlled trial
law
Influenza, Human
Risk of mortality
Humans
Medicine
Obesity
Endothelial dysfunction
Pandemics
030109 nutrition & dietetics
Pandemic
SARS-CoV-2
business.industry
Diabetes
COVID-19
General Medicine
medicine.disease
Influenza
Adipose Tissue
Metabolism (M Dalamaga, Section Editor)
Observational study
Therapy
medicine.symptom
Infection
business
Obesity paradox
Subjects
Details
- ISSN :
- 21624968
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Current Obesity Reports
- Accession number :
- edsair.doi.dedup.....8046ac5e3e7bd19282e6fc883d00691a