Abstract
Obesity prevails worldwide to an increasing effect. For example, up to 42% of American adults are considered obese. Obese individuals are prone to a variety of complications of metabolic disorders including diabetes mellitus, hypertension, cardiovascular disease, and chronic kidney disease. Recent meta-analyses of clinical studies in patient cohorts in the ongoing coronavirus-disease 2019 (COVID-19) pandemic indicate that the presence of obesity and relevant disorders is linked to a more severe prognosis of COVID-19. Given the significance of obesity in COVID-19 progression, we provide a review of host metabolic and immune responses in the immunometabolic dysregulation exaggerated by obesity and the viral infection that develops into a severe course of COVID-19. Moreover, sequela studies of individuals 6 months after having COVID-19 show a higher risk of metabolic comorbidities including obesity, diabetes, and kidney disease. These collectively implicate an inter-systemic dimension to understanding the association between obesity and COVID-19 and suggest an interdisciplinary intervention for relief of obesity-COVID-19 complications beyond the phase of acute infection.
Highlights
A study examining 247 COVID-19 patients showed that higher levels of cardiorespiratory fitness (CRF) are associated with lower hospitalization rates, suggesting that fitness is more critical than adiposity in predicting the risk for COVID-19 hospitalization and potential for severe COVID-19 [38]
About 4 weeks after respiratory infection by SARS-CoV-2, COVID-19 manifests a wide range of symptoms in people influenced by different demographic factors including age, FIGURE 1 | Immunometabolic proxies underlying the association between obesity and the severe course of COVID-19
In addition to the pathogenic impact triggered by local viral infections such as airway inflammation and pneumonia, major pathologies underlying severe COVID-19 come from the excessive immune response [33]
Summary
About half of the studies compared virus prevalence in obese with non-obese individuals, indicating a higher ratio at 10.5%–68.2% of positive diagnosed in the obese population considering that the average country-wide infection ratio of SARS-CoV-2 is 2%–10% (Table 1 and Supplement Excel Sheet) [12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32]. About 4 weeks after respiratory infection by SARS-CoV-2, COVID-19 manifests a wide range of symptoms in people influenced by different demographic factors including age, FIGURE 1 | Immunometabolic proxies underlying the association between obesity and the severe course of COVID-19.
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