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肥胖对严重急性呼吸综合征冠状病毒2感染的影响:利弊与“肥胖悖论”——一项系统综述

Obesity Impact on SARS-CoV-2 Infection: Pros and Cons "Obesity Paradox"-A Systematic Review.

作者信息

Vulturar Damiana-Maria, Crivii Carmen-Bianca, Orăsan Olga Hilda, Palade Emanuel, Buzoianu Anca-Dana, Zehan Iulia Georgiana, Todea Doina Adina

机构信息

Department of Pneumology, Iuliu Hațieganu University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania.

Morphological Sciences Department, Iuliu Hațieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2022 Jul 2;11(13):3844. doi: 10.3390/jcm11133844.

Abstract

BACKGROUND

During the last years, the COVID-19 pandemic meets the pandemic generated by obesity, raising many questions regarding the outcomes of those with severe forms of infection.

METHODS

The present systematic review summarises and analyses the data providing evidence for or against the "obesity-paradox" in COVID-19 patients. After applying the inclusion and exclusion criteria, 23 studies were included. We also analysed the presumably underlying basic mechanisms.

RESULTS

The patients with a body mass index (BMI) of 30-40 kg/m presented severe symptoms that led to intensive care unit (ICU) admission but not increased death rate. Those with a higher degree of obesity, with a BMI higher than 40 kg/m, led to a rise in the death rate, particularly in young patients. Obesity was associated with a higher rate of ICU admission but was not determined as an independent predictor of increased mortality. In contrast, some studies suggest a strong association between obesity or morbid obesity and the risk of death.

CONCLUSIONS

The existence of "obesity-paradox" cannot be stated; our study presents obesity as a critical risk factor in the evolution of COVID-19.

摘要

背景

在过去几年中,新冠疫情与肥胖引发的大流行相遇,引发了许多关于重症感染患者预后的问题。

方法

本系统综述总结并分析了为支持或反对新冠患者中“肥胖悖论”提供证据的数据。应用纳入和排除标准后,纳入了23项研究。我们还分析了可能的潜在基本机制。

结果

体重指数(BMI)为30至40kg/m²的患者出现严重症状,导致入住重症监护病房(ICU),但死亡率并未增加。肥胖程度更高、BMI高于40kg/m²的患者死亡率上升,尤其是年轻患者。肥胖与更高的ICU入住率相关,但未被确定为死亡率增加的独立预测因素。相比之下,一些研究表明肥胖或病态肥胖与死亡风险之间存在密切关联。

结论

无法确定“肥胖悖论”的存在;我们的研究表明肥胖是新冠疫情发展中的一个关键风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24f7/9267674/9f1fec695160/jcm-11-03844-g001.jpg

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