Obésité et COVID-19 : le choc fatal entre deux pandémies

The current pandemic caused by the coronavirus 2019 (COVID-19) is superimposed on another well-known pandemic in our society, that of overweight and obesity. Obesity represents a higher risk of severe COVID-19 infection, which may lead to the requirement of a mechanical ventilation in intensive care units (ICU) and premature death. The underlying mechanisms are multiple: alteration of the respiratory performance, presence of comorbidities such as diabetes, hypertension or obstructive sleep apnea, finally inadequate and excessive immunological and inflammatory responses, possibly aggravated by ectopic intrathoracic fat deposits. Thus, COVID-19 may challenge the so-called “obesity paradox” commonly reported in ICU among patients with acute respiratory distress syndrome. Furthermore, the presence of obesity increases the risk of worse outcome at a younger age. These findings require reinforced preventive and curative measures among obese patients to limit the risk of progression towards an unfavorable outcome in case of COVID-19.