Mechanick Jeffrey I, Christofides Elena A, Marchetti Albert E, Hoddy Kristin K, Joachim Jim, Hegazi Refaat, Hamdy Osama
The Wiener Cardiovascular Institute/Marie-Josée and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart, New York, NY, United States.
Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Front Nutr. 2023 Feb 21;10:1122203. doi: 10.3389/fnut.2023.1122203. eCollection 2023.
The coronavirus disease 2019 (COVID-19) pandemic challenges our collective understanding of transmission, prevention, complications, and clinical management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Risk factors for severe infection, morbidity, and mortality are associated with age, environment, socioeconomic status, comorbidities, and interventional timing. Clinical investigations report an intriguing association of COVID-19 with diabetes mellitus and malnutrition but incompletely describe the triphasic relationship, its mechanistic pathways, and potential therapeutic approaches to address each malady and their underlying metabolic disorders. This narrative review highlights common chronic disease states that interact epidemiologically and mechanistically with the COVID-19 to create a syndromic phenotype-the COVID-Related Cardiometabolic Syndrome-linking cardiometabolic-based chronic disease drivers with pre-, acute, and chronic/post-COVID-19 disease stages. Since the association of nutritional disorders with COVID-19 and cardiometabolic risk factors is well established, a syndromic triad of COVID-19, type 2 diabetes, and malnutrition is hypothesized that can direct, inform, and optimize care. In this review, each of the three edges of this network is uniquely summarized, nutritional therapies discussed, and a structure for early preventive care proposed. Concerted efforts to identify malnutrition in patients with COVID-19 and elevated metabolic risks are needed and can be followed by improved dietary management while simultaneously addressing dysglycemia-based chronic disease and malnutrition-based chronic disease.
2019年冠状病毒病（COVID-19）大流行对我们对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的传播、预防、并发症及临床管理的集体认知提出了挑战。严重感染、发病及死亡的风险因素与年龄、环境、社会经济地位、合并症及干预时机相关。临床研究报告了COVID-19与糖尿病及营养不良之间存在有趣的关联，但未完整描述这三者之间的关系、其作用机制途径以及针对每种疾病及其潜在代谢紊乱的潜在治疗方法。本叙述性综述重点介绍了一些常见的慢性疾病状态，这些状态在流行病学和机制上与COVID-19相互作用，形成一种综合征表型——COVID-相关心脏代谢综合征，将基于心脏代谢的慢性疾病驱动因素与COVID-19感染前、急性感染期及慢性感染后/康复期联系起来。鉴于营养紊乱与COVID-19及心脏代谢风险因素之间的关联已得到充分证实，因此推测存在一个由COVID-19、2型糖尿病和营养不良组成的综合征三联征，这可以指导、告知并优化治疗。在本综述中，对该网络的三个方面分别进行了独特总结，讨论了营养疗法，并提出了早期预防护理的框架。需要共同努力识别COVID-19患者中存在的营养不良及代谢风险升高的情况，随后可改善饮食管理，同时应对基于血糖异常的慢性疾病和基于营养不良的慢性疾病。
