Skip to main content Skip to main navigation menu Skip to site footer
MedNext Journal of Medical and Health Sciences
Articles
DOI: 10.34256/mdnt2135
Submitted: 16-09-2021
Published: 10-06-2021

COVID-19: Major Metabolic and Immunological Relationships in Obesity

UNILAGO - Uniao Das Faculdades Dos Grandes Lagos - Medical School, Sao Jose do Rio Preto/SP, Brazil
FUNFARME – Base Hospital, Sao Jose do Rio Preto, Sao Paulo, Brazil
SARS-CoV-2 COVID-19 Obesity Meta-inflammation Metabolism Immunity

Abstract

Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There are a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of metainflammation.

Metrics

Metrics Loading ...

References

  1. OMS- Organização Mundial de Saúde. Disponível em: https://www.sbcbm.org.br/endoscopia-e-obesidade/ Acesso em: 16 de abril de 2020.
  2. Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica, (2016) Diretrizes brasileiras de obesidade, Sao Paulo. https://abeso.org.br/ Acessado em 28 Agosto de 2020.
  3. D.A Kass, P. Duggal, O. Cingolani, Obesity could shift severe COVID-19 disease to younger ages, The Lancet, 39 (2020) 1544-1545.
  4. Miet Schetz, Audrey De Jong, Adam M Deane, Wilfried Druml, Pleun Hemelaar, Paolo Pelosi, Peter Pickkers, Annika Reintam-Blaser, Jason Roberts, Yasser Sakr, Samir Jaber Obesity in the critically ill: a narrative review, Intensive care medicine, 45 (2019) 757‐769.
  5. C.M. Apovian, Obesity: definition, comorbidities, causes, and burden, American Journal of Managed Care, 22 (2016) 176-185.
  6. C. Andolfi, P.M. Fisichella, Epidemiology of Obesity and Associated Comorbidities, Journal of Laparoendoscopic & Advanced Surgical Techniques, 28 (2018) 919‐924.
  7. H. Ghanim, A. Aljada, D. Hofmeyer, T. Syed, P. Mohanty, P. Dandona, Circulating Mononuclear Cells in the Obese Are in a Proinflammatory State, Circulation, 110 (2004) 1564-1571.
  8. Z. Varga, A.J. Flammer, P. Steiger, M. Haberecker, R. Andermatt, A.S. Zinkernagel, M.R Mehra, R.A Schuepbach, F. Ruschitzka, H.Moch, Endothelial cell infection and endotheliitis in COVID-19, Lancet 395 (2020) 1417-1418.
  9. M. Ackermann, S.E. Verleden, M. Kuehnel, A. Haverich, T. Welte, F. Laenger, A. Vanstapel, C. Werlein, H. Stark, A. Tzankov, W.W. Li, V.W. Li, S.J. Mentzer, D. Jonigk, Pulmonary Vascular Endothelialitis, Thrombosis, and Angiogenesis in Covid-19 New England Journal of Medicine, 383 (2020) 120-128.
  10. S. Bhatheja, H. B. Panchal, H. Ventura, T.K. Paul, Obesity cardiomyopathy: pathophysiologic factors and nosologic reevaluation, The American journal of the medical sciences, 352 (2016) 219-222.
  11. M.J Cummings, M.R Baldwin, D.Abrams, S.D Jacobson, B.J Meyer, E.M Balough, J.G Aaron, J.Claassen, L.E Rabbani, J. Hastie, B.R Hochman, J.S. Schicchi, N.H. Yip, D. Brodie, Max R O'Donnell, Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study, The Lancet, 395 (2020) 1763-1770.
  12. S. Richardson, J.S Hirsch, M. Narasimhan, J.M Crawford, T. McGinn, K.W. Davidson, the Northwell COVID-19 Research Consortium, D.P Barnaby, L.B. Becker, J.D. Chelico, S.L Cohen, J. Cookingham, K. Coppa, M.A. Diefenbach, A. J. Dominello, J. D. Hefele, L. Falzon, J. Gitlin, N. Hajizadeh, T.G. Harvin, D.A. Hirschwerk, E.J. Kim, Z.M. Kozel, L.M. Marrast, J.N Mogavero, G.A. Osorio, M. Qiu, T.P. Zanos, Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area, Jama, 323 [2020] 2052-2059.
  13. M. Kalligeros, F. Shehadeh, E.K. Mylona, G.Benitez, C.G. Beckwith, P.A. Chan, E. Mylonakis, Association of obesity with disease severity among patients with coronavirus disease 2019. Obesity, 28 (2020) 1200-1204.
  14. R.C. Becker, COVID-19 update: Covid-19-associated coagulopathy, Journal of thrombosis and thrombolysis, 50 (2020) 54-67.
  15. I.L. Kruglikov, P.E. Scherer, The role of adipocytes and adipocyte‐like cells in the severity of COVID‐19 infections. Obesity, 28 (2020) 1187-1190.

How to Cite

Tolentino Chaves, M., & Tolentino Chaves, A. P. (2021). COVID-19: Major Metabolic and Immunological Relationships in Obesity. MedNEXT Journal of Medical and Health Sciences, 2(3), 26–31. https://doi.org/10.34256/mdnt2135