Pérez-Galarza Jorge, Prócel César, Cañadas Cristina, Aguirre Diana, Pibaque Ronny, Bedón Ricardo, Sempértegui Fernando, Drexhage Hemmo, Baldeón Lucy
Research Institute of Biomedicine, Central University of Ecuador, Quito 170201, Ecuador.
Faculty of Medicine, Central University of Ecuador, Quito 170403, Ecuador.
Vaccines (Basel). 2021 Jan 29;9(2):102. doi: 10.3390/vaccines9020102.
In December 2019, a novel coronavirus known as SARS-CoV-2 was first detected in Wuhan, China, causing outbreaks of the coronavirus disease COVID-19 that has now spread globally. For this reason, The World Health Organization (WHO) declared COVID-19 a public health emergency in March 2020. People living with pre-existing conditions such as obesity, cardiovascular diseases, type 2 diabetes (T2D), and chronic kidney and lung diseases, are prone to develop severe forms of disease with fatal outcomes. Metabolic diseases such as obesity and T2D alter the balance of innate and adaptive responses. Both diseases share common features characterized by augmented adiposity associated with a chronic systemic low-grade inflammation, senescence, immunoglobulin glycation, and abnormalities in the number and function of adaptive immune cells. In obese and T2D patients infected by SARS-CoV-2, where immune cells are already hampered, this response appears to be stronger. In this review, we describe the abnormalities of the immune system, and summarize clinical findings of COVID-19 patients with pre-existing conditions such as obesity and T2D as this group is at greater risk of suffering severe and fatal clinical outcomes.
2019年12月,一种名为严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的新型冠状病毒首次在中国武汉被发现,引发了新型冠状病毒肺炎(COVID-19)疫情,目前该疫情已在全球蔓延。因此,世界卫生组织(WHO)于2020年3月宣布COVID-19为突发公共卫生事件。患有肥胖症、心血管疾病、2型糖尿病(T2D)以及慢性肾脏和肺部疾病等基础疾病的人群,更容易发展为重症疾病并导致致命后果。肥胖症和T2D等代谢性疾病会改变先天性和适应性免疫反应的平衡。这两种疾病具有共同特征,表现为脂肪增多,并伴有慢性全身性低度炎症、衰老、免疫球蛋白糖基化以及适应性免疫细胞数量和功能异常。在感染了SARS-CoV-2的肥胖症和T2D患者中,由于免疫细胞已经受到损害,这种反应似乎更为强烈。在这篇综述中,我们描述了免疫系统的异常情况,并总结了患有肥胖症和T2D等基础疾病COVID-19患者的临床研究结果,因为这一群体出现严重和致命临床后果的风险更高。