Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Int J Obes (Lond). 2021 May;45(5):998-1016. doi: 10.1038/s41366-021-00776-8. Epub 2021 Feb 26.
Recent studies have shown that obesity is associated with the severity of coronavirus disease (COVID-19). We reviewed clinical studies to clarify the obesity relationship with COVID-19 severity, comorbidities, and discussing possible mechanisms.
The electronic databases, including Web of Science, PubMed, Scopus, and Google Scholar, were searched and all studies conducted on COVID-19 and obesity were reviewed. All studies were independently screened by reviewers based on their titles and abstracts.
Forty relevant articles were selected, and their full texts were reviewed. Obesity affects the respiratory and immune systems through various mechanisms. Cytokine and adipokine secretion from adipose tissue leads to a pro-inflammatory state in obese patients, predisposing them to thrombosis, incoordination of innate and adaptive immune responses, inadequate antibody response, and cytokine storm. Obese patients had a longer virus shedding. Obesity is associated with other comorbidities such as hypertension, cardiovascular diseases, diabetes mellitus, and vitamin D deficiency. Hospitalization, intensive care unit admission, mechanical ventilation, and even mortality in obese patients were higher than normal-weight patients. Obesity could alter the direction of severe COVID-19 symptoms to younger individuals. Reduced physical activity, unhealthy eating habits and, more stress and fear experienced during the COVID-19 pandemic may result in more weight gain and obesity.
Obesity should be considered as an independent risk factor for the severity of COVID-19. Paying more attention to preventing weight gain in obese patients with COVID-19 infection in early levels of disease is crucial during this pandemic.
最近的研究表明，肥胖与冠状病毒病（COVID-19）的严重程度有关。我们回顾了临床研究，以阐明肥胖与 COVID-19 严重程度、合并症的关系，并讨论了可能的机制。
检索了电子数据库，包括 Web of Science、PubMed、Scopus 和 Google Scholar，并综述了所有关于 COVID-19 和肥胖的研究。两位审稿人根据标题和摘要独立筛选所有研究。
选择了 40 篇相关文章，并对其全文进行了回顾。肥胖通过多种机制影响呼吸系统和免疫系统。脂肪组织分泌的细胞因子和脂肪因子导致肥胖患者出现促炎状态，使他们容易发生血栓形成、固有和适应性免疫反应不协调、抗体反应不足和细胞因子风暴。肥胖患者的病毒脱落时间更长。肥胖与其他合并症有关，如高血压、心血管疾病、糖尿病和维生素 D 缺乏。肥胖患者的住院、入住重症监护病房、机械通气，甚至死亡率均高于体重正常的患者。肥胖可能会改变 COVID-19 严重症状在年轻人群中的发展方向。在 COVID-19 大流行期间，减少体力活动、不良饮食习惯以及更多的压力和恐惧可能导致体重增加和肥胖。
肥胖应被视为 COVID-19 严重程度的独立危险因素。在大流行期间，对于 COVID-19 感染的肥胖患者，在疾病早期阶段更应注意预防体重增加。
