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COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship
During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563353/ https://www.ncbi.nlm.nih.gov/pubmed/34799284 http://dx.doi.org/10.1016/j.orcp.2021.10.006 |
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author | Manolis, Antonis S. Manolis, Antonis A. Manolis, Theodora A. Apostolaki, Naomi E. Melita, Helen |
author_facet | Manolis, Antonis S. Manolis, Antonis A. Manolis, Theodora A. Apostolaki, Naomi E. Melita, Helen |
author_sort | Manolis, Antonis S. |
collection | PubMed |
description | During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings are consistent, the higher the body mass index (BMI) the worse the outcomes. Ectopic (visceral) obesity also promotes proinflammatory, prothrombotic, and vasoconstrictive states, thus enhancing the deleterious effects of COVID-19 disease. Less, albeit robust, evidence also exists for a higher risk of COVID-19 infection incurred with underweight. Thus, the relationship of COVID-19 and BMI has a J-curve pattern, where patients with both overweight/obesity and underweight are more susceptible to the ailments of COVID-19. The pathophysiology underlying this link is multifactorial, mostly relating to the inflammatory state characterizing obesity, the impaired immune response to infectious agents coupled with increased viral load, the overexpression in adipose tissue of the receptors and proteases for viral entry, an increased sympathetic activity, limited cardiorespiratory reserve, a prothrombotic milieu, and the associated comorbidities. All these issues are herein reviewed, the results of large studies and meta-analyses are tabulated and the pathogenetic mechanisms and the BMI relationship with COVID-19 are pictorially illustrated. |
format | Online Article Text |
id | pubmed-8563353 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-85633532021-11-03 COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship Manolis, Antonis S. Manolis, Antonis A. Manolis, Theodora A. Apostolaki, Naomi E. Melita, Helen Obes Res Clin Pract Review During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings are consistent, the higher the body mass index (BMI) the worse the outcomes. Ectopic (visceral) obesity also promotes proinflammatory, prothrombotic, and vasoconstrictive states, thus enhancing the deleterious effects of COVID-19 disease. Less, albeit robust, evidence also exists for a higher risk of COVID-19 infection incurred with underweight. Thus, the relationship of COVID-19 and BMI has a J-curve pattern, where patients with both overweight/obesity and underweight are more susceptible to the ailments of COVID-19. The pathophysiology underlying this link is multifactorial, mostly relating to the inflammatory state characterizing obesity, the impaired immune response to infectious agents coupled with increased viral load, the overexpression in adipose tissue of the receptors and proteases for viral entry, an increased sympathetic activity, limited cardiorespiratory reserve, a prothrombotic milieu, and the associated comorbidities. All these issues are herein reviewed, the results of large studies and meta-analyses are tabulated and the pathogenetic mechanisms and the BMI relationship with COVID-19 are pictorially illustrated. Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. 2021 2021-11-03 /pmc/articles/PMC8563353/ /pubmed/34799284 http://dx.doi.org/10.1016/j.orcp.2021.10.006 Text en © 2021 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Review Manolis, Antonis S. Manolis, Antonis A. Manolis, Theodora A. Apostolaki, Naomi E. Melita, Helen COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship |
title | COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship |
title_full | COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship |
title_fullStr | COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship |
title_full_unstemmed | COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship |
title_short | COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship |
title_sort | covid-19 infection and body weight: a deleterious liaison in a j-curve relationship |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563353/ https://www.ncbi.nlm.nih.gov/pubmed/34799284 http://dx.doi.org/10.1016/j.orcp.2021.10.006 |
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