Scheen André J
Service de diabétologie, nutrition et maladies métaboliques, Département de médecine, CHU Liège, Liège Université, 4000 Liège, Belgique.
Rev Med Suisse. 2020 May 27;16(695):1115-1119.
Obesity represents a higher risk of severe COVID-19 infection, which may lead to the requirement of a mechanical ventilation in intensive care units and premature death. The underlying mechanisms are multiple: alteration of the respiratory performance, presence of comorbidities such as diabetes, hypertension or obstructive sleep apnea, finally inadequate and excessive immunological responses, possibly aggravated by ectopic intrathoracic fat depots. Thus, COVID-19 may challenge the so-called « obesity paradox » commonly reported by intensivists in patients with acute respiratory distress syndrome. These findings require reinforced preventive and curative measures among obese patients to limit the risk of progression towards an unfavorable outcome in case of COVID-19.
肥胖会增加感染重症 COVID-19 的风险，这可能导致在重症监护病房需要机械通气并引发过早死亡。其潜在机制是多方面的：呼吸功能改变、存在糖尿病、高血压或阻塞性睡眠呼吸暂停等合并症，最后是免疫反应不足和过度，胸腔内异位脂肪堆积可能会加剧这种情况。因此，COVID-19 可能会挑战重症监护医生在急性呼吸窘迫综合征患者中普遍报告的所谓“肥胖悖论”。这些发现要求对肥胖患者加强预防和治疗措施，以限制在感染 COVID-19 时进展为不良结局的风险。
