COVID‐19 infection, progression, and vaccination: Focus on obesity and related metabolic disturbances

Abstract

Summary Coronaviruses are constantly circulating in humans, causing common colds and mild respiratory infections. In contrast, infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), responsible for coronavirus disease‐2019 (COVID‐19), can cause additional severe complications, particularly in patients with obesity and associated metabolic disturbances. Obesity is a principal causative factor in the development of the metabolic syndrome; a series of physiological, biochemical, clinical, and metabolic factors that increase the risk of obesity‐associated diseases. “Metabolically unhealthy” obesity is, in addition to metabolic disturbances, also associated with immunological disturbances. As such, patients with obesity are more prone to develop serious complications from infections, including those from SARS‐CoV‐2. In this review, we first describe how obesity and related metabolic disturbances increase the risk of SARS‐CoV‐2 infection. Then, mechanisms contributing to COVID‐19 complications and poor prognosis in these patients are discussed. Finally, we discuss how obesity potentially reduces long‐term COVID‐19 vaccination efficacy. Despite encouraging COVID‐19 vaccination results in patients with obesity and related metabolic disturbances in the short‐term, it is becoming increasingly evident that long‐term COVID‐19 vaccination efficacy should be closely monitored in this vulnerable group.

When to operate after SARS-CoV-2 infection? A review on the recent consensus recommendation of the DGC/BDC and the DGAI/BDA

“…male gender, diabetes mellitus type II, advanced age and cardiovascular disease [ 30 , 120 – 128 ]. Obese patients in particular are at increased risk of SARS-CoV-2 infection with a severe course [ 129 ]. This is particularly evident in ICU patients with COVID-19 [ 130 ].…”

Rapid Weight Loss, Central Obesity Improvement and Blood Glucose Reduction Are Associated with a Stronger Adaptive Immune Response Following COVID-19 mRNA Vaccine

“…This is unsurprising as obesity is associated with immune dysfunction: those with obesity are more susceptible to infections and more at risk of developing complications on infection [6,7]. Interestingly, evidence also supports a link between obesity and poor seroconversion upon administration of some vaccines such as tetanus, hepatitis B and influenza virus [8,9], together with an increased risk of infection even when the seroconversion seems robust [10]. As we have previously reported, central obesity is also associated with lower antibody levels following an mRNA COVID-19 vaccine [11].…”

Metabolite profile of COVID-19 revealed by UPLC-MS/MS-based widely targeted metabolomics

“…Viral infections perturb the host metabolism, and the outcome depends on the stage of viral infection ( 2 ). Using mass spectrometry-based metabolomics, Shen et al.…”