Abstract
To investigate the mechanisms underlying the SARS-CoV-2 infection severity observed in patients with obesity, we performed a prospective study of 51 patients evaluating the impact of multiple immune parameters during 2 weeks after admission, on vital organs’ functions according to body mass index (BMI) categories. High-dimensional flow cytometric characterization of immune cell subsets was performed at admission, 30 systemic cytokines/chemokines levels were sequentially measured, thirteen endothelial markers were determined at admission and at the zenith of the cytokines. Computed tomography scans on admission were quantified for lung damage and hepatic steatosis (n = 23). Abnormal BMI (> 25) observed in 72.6% of patients, was associated with a higher rate of intensive care unit hospitalization (p = 0.044). SARS-CoV-2 RNAaemia, peripheral immune cell subsets and cytokines/chemokines were similar among BMI groups. A significant association between inflammatory cytokines and liver, renal, and endothelial dysfunctions was observed only in patients with obesity (BMI > 30). In contrast, early signs of lung damage (ground-glass opacity) correlated with Th1/M1/inflammatory cytokines only in normal weight patients. Later lesions of pulmonary consolidation correlated with BMI but were independent of cytokine levels. Our study reveals distinct physiopathological mechanisms associated with SARS-CoV-2 infection in patients with obesity that may have important clinical implications.
Highlights
Coronavirus disease 2019 (COVID-19), first identified on December 2019, is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [1, 2]
All patients were diagnosed with COVID-19, i.e. positive for SARS-CoV-2 nucleic acid on real-time reverse transcription-polymerase chain reaction (RT-protein/creatine ratio (PCR)) assays of nasopharyngeal swab specimens, in accordance with the World Health Organization (WHO) COVID-19 technical guidance
Our study reveals distinct physiopathological mechanism associated with severe COVID-19 in patients with obesity
Summary
Coronavirus disease 2019 (COVID-19), first identified on December 2019, is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) [1, 2]. If low socioeconomic status [6] has been reported as risk factors for being infected, severe form of COVID-19 is mainly observed in patients of advanced age; with the 14.8%-20.2% fatality rate for adults older than 80 years [7] It affects younger male patients with preexisting moderate comorbidities i.e. type II diabetes (33.8%), high blood pressure (56.6%), and overweight (41.7%), in US patients requiring hospitalization [8]. Obesity is considered as a state of excessive fat accumulation caused by a disruption of energy balance It is marked by enhanced pro-inflammatory factors in blood and infiltration of immune cells in white adipose tissue. Signs of liver dysfunction [21], acute kidney injury [22], and endothelium activation [23] have been reported in critically ill patients with COVID-19, their association with obesity and inflammatory disorders remains elusive
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
