Oral Biotechnology and Bioengineering, Department of Cranio-Maxillofacial and Oral Surgery, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.
Centre for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland.
Front Endocrinol (Lausanne). 2020 Oct 6;11:556962. doi: 10.3389/fendo.2020.556962. eCollection 2020.
From the beginning of 2020, the governments and the health systems around the world are tackling infections and fatalities caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) resulting in the coronavirus disease 2019 (COVID-19). This virus pandemic has turned more complicated as individuals with co-morbidities like diabetes, cardiovascular conditions and obesity are at a high risk of acquiring infection and suffering from a more severe course of disease. Prolonged viral infection and obesity are independently known to lower the immune response and a combination can thus result in a "cytokine storm" and a substantial weakening of the immune system. With the rise in obesity cases globally, the chances that obese individuals will acquire infection and need hospitalization are heightened. In this review, we discuss why obesity, a low-grade chronic inflammation, contributes toward the increased severity in COVID-19 patients. We suggest that increased inflammation, activation of renin-angiotensin-aldosterone system, elevated adipokines and higher ectopic fat may be the factors contributing to the disease severity, in particular deteriorating the cardiovascular and lung function, in obese individuals. We look at the many lessons learnt from the 2009 H1N1 influenza A pandemic and relate it to the very little but fast incoming information that is available from the SARS-CoV-2 infected individuals with overweight and obesity.
自 2020 年初以来，全球各国政府和卫生系统一直在应对由新型严重急性呼吸系统综合症冠状病毒（SARS-CoV-2）引起的感染和死亡，导致 2019 年冠状病毒病（COVID-19）。由于患有糖尿病、心血管疾病和肥胖症等合并症的个体感染风险较高，病情也更为严重，这种病毒大流行变得更加复杂。众所周知，长期病毒感染和肥胖会降低免疫反应，两者结合可能会导致“细胞因子风暴”，并显著削弱免疫系统。随着肥胖症在全球范围内的增加，肥胖个体感染并需要住院治疗的几率也会增加。在这篇综述中，我们讨论了为什么肥胖，一种低度慢性炎症，会导致 COVID-19 患者的病情加重。我们认为，炎症增加、肾素-血管紧张素-醛固酮系统的激活、脂肪因子升高和异位脂肪增加可能是导致肥胖个体疾病严重程度的因素，特别是会恶化心血管和肺部功能。我们还研究了 2009 年 H1N1 流感大流行中吸取的许多经验教训，并将其与 SARS-CoV-2 感染超重和肥胖个体时获得的少量但快速的信息进行了关联。
