Abstract
From the beginning of 2020, the governments and the health systems around the world are tackling infections and fatalities caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) resulting in the coronavirus disease 2019 (COVID-19). This virus pandemic has turned more complicated as individuals with co-morbidities like diabetes, cardiovascular conditions and obesity are at a high risk of acquiring infection and suffering from a more severe course of disease. Prolonged viral infection and obesity are independently known to lower the immune response and a combination can thus result in a “cytokine storm” and a substantial weakening of the immune system. With the rise in obesity cases globally, the chances that obese individuals will acquire infection and need hospitalization are heightened. In this review, we discuss why obesity, a low-grade chronic inflammation, contributes toward the increased severity in COVID-19 patients. We suggest that increased inflammation, activation of renin-angiotensin-aldosterone system, elevated adipokines and higher ectopic fat may be the factors contributing to the disease severity, in particular deteriorating the cardiovascular and lung function, in obese individuals. We look at the many lessons learnt from the 2009 H1N1 influenza A pandemic and relate it to the very little but fast incoming information that is available from the SARS-CoV-2 infected individuals with overweight and obesity.
Highlights
In the last 50 years, obesity has gradually shaped into a pandemic
With the increased frequency of viral infections, the cost of obesity gets even higher. At this time, when the world is facing a pandemic with the novel corona virus (SARS-CoV-2), it is important to use our current understanding on the connection between viral infection and obesity
We suggest that obesity favors viral infection
Summary
In the last 50 years, obesity has gradually shaped into a pandemic. Obesity (body mass index (BMI), ≥30 kg /m2) is a combination of genetic, behavioral and environmental variables, and the number of affected individuals has doubled in more than 70 countries. A study by the World Health Organization (WHO), with H1N1 infection involving 70,000 individuals from 19 countries provide evidence that obesity, morbid obesity (BMI > 40), is a risk factor for severe disease [14]. A correlation between obesity and infections is suggested by humans and rodent studies [16, 17] and reflects the reduced ability of immune cells from obese individuals to fight viral infection. With the increased frequency of viral infections, the cost of obesity gets even higher At this time, when the world is facing a pandemic with the novel corona virus (SARS-CoV-2), it is important to use our current understanding on the connection between viral infection and obesity. In the light of the lessons, we learned from the H1N1 influenza A virus pandemic in an obese setting, this review discusses why obese individuals are at risk during this SARS-CoV-2 pandemic
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