De Groot Cornelis Jan, Poitou Bernert Christine, Coupaye Muriel, Clement Karine, Paschou Stavroula A, Charmandari Evangelia, Kanaka-Gantenbein Christina, Wabitsch Martin, Buddingh Emilie P, Nieuwenhuijsen Barbara, Marina Ljiljana, Johannsson Gudmundur, Van Den Akker E L T
Pediatric Endocrinology and Obesity Center CGG Erasmus MC, Rotterdam and Willem Alexander Children's Hospital, LUMC, Leiden, the Netherlands.
Assistance Publique-Hôpitaux de Paris, Reference Center for Rare Diseases (PRADORT, Prader-Willi Syndrome and other rare obesities), Nutrition Department, Pitié-Salpêtrière hospital, Paris, France.
Endocrine. 2021 Mar;71(3):653-662. doi: 10.1007/s12020-021-02619-y. Epub 2021 Jan 29.
This article aims to provide guidance on prevention and treatment of COVID-19 in patients with genetic obesity. Key principals of the management of patients with genetic obesity during COVID-19 pandemic for patients that have contracted COVID-19 are to be aware of: possible adrenal insufficiency (e.g., POMC deficiency, PWS); a more severe course in patients with concomitant immunodeficiency (e.g., LEP and LEPR deficiency), although defective leptin signalling could also be protective against the pro-inflammatory phenotype of COVID-19; disease severity being masked by insufficient awareness of symptoms in syndromic obesity patients with intellectual deficit (in particular PWS); to adjust medication dose to increased body size, preferably use dosing in m2; the high risk of malnutrition in patients with Sars-Cov2 infection, even in case of obesity. Key principals of the obesity management during the pandemic are to strive for optimal obesity management and a healthy lifestyle within the possibilities of the regulations to prevent weight (re)gain and to address anxiety within consultations, since prevalence of anxiety for COVID-19 is underestimated.
本文旨在为患有遗传性肥胖症的新冠患者提供预防和治疗指导。对于已感染新冠的遗传性肥胖患者，在新冠疫情期间管理此类患者的关键原则如下：要意识到可能存在肾上腺功能不全（如促黑素细胞激素缺乏、普拉德-威利综合征）；合并免疫缺陷的患者（如瘦素缺乏和瘦素受体缺乏）病程可能更严重，尽管瘦素信号缺陷也可能对新冠的促炎表型具有保护作用；患有智力缺陷的综合征性肥胖患者（尤其是普拉德-威利综合征）可能因对症状认识不足而掩盖疾病严重程度；根据体型增大调整药物剂量，最好采用按体表面积给药；即使肥胖，感染新冠病毒的患者也有很高的营养不良风险。疫情期间肥胖管理的关键原则是在法规允许的范围内努力实现最佳肥胖管理和健康生活方式，以防止体重反弹，并在咨询过程中解决焦虑问题，因为新冠焦虑症的患病率被低估了。
