Review: Obesity and COVID-19: A Detrimental Intersection

Gammone, Maria Alessandra; D’Orazio, Nicolantonio

doi:10.3389/fendo.2021.652639

Cited by 27 publications

(24 citation statements)

References 59 publications

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“…Recent literature data suggest that in addition to the well-established association between BMI-based obesity and severe COVID-19 outcome, the body fat distribution is also important; in particular, visceral adipose tissue and upper abdominal circumference have been proposed as simple tools for risk assessment in COVID-19 patients [ 122 , 123 , 124 , 125 ]. More recently, an interesting prospective multicenter study on hospitalized COVID-19 patients with respiratory failure showed that a larger neck circumference phenotype patient is more prone to have a negative outcome, a large neck being associated with an increased proinflammatory and prothrombotic status.…”

Section: Implications Of the Findings And Future Perspectivesmentioning

confidence: 99%

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Ragnoli

Pochetti

Pignatti

et al. 2022

IJERPH

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Sleep health and its adaptation to individual and environmental factors are crucial to promote physical and mental well-being across animal species. In recent years, increasing evidence has been reported regarding the relationship between sleep and the immune system and how sleep disturbances may perturb the delicate balance with severe repercussions on health outcomes. For instance, experimental sleep deprivation studies in vivo have reported several major detrimental effects on immune health, including induced failure of host defense in rats and increased risk for metabolic syndrome (MetS) and immune suppression in humans. In addition, two novel risk factors for dysregulated metabolic physiology have recently been identified: sleep disruption and circadian misalignment. In light of these recent findings about the interplay between sleep and the immune system, in this review, we focus on the relationship between sleep deprivation and immunity against viruses, with a special interest in SARS-CoV-2 infection.

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Section: Implications Of the Findings And Future Perspectivesmentioning

confidence: 99%

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Ragnoli

Pochetti

Pignatti

et al. 2022

IJERPH

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“…Population ageing and rise in obesity prevalence worldwide are the two biggest risk factors for non-communicable diseases, including degenerative diseases, sarcopenia, frailty, dementia, increased morbidity, and mortality putting a strain on finite healthcare resources (1)(2)(3)(4)(5). Physical inactivity during COVID-19 has further exacerbated the problem (6), and obesity has been recognized as the strongest risk for severe disease and mortality during COVID-19 (7). Elevated body mass index (BMI), waist circumference and/or waist hip ratio are often used to define obesity.…”

Section: Introductionmentioning

confidence: 99%

“…Thereafter, the fat depot starts to decline with increasing ectopic fat deposition in the epicardium, bone marrow, muscle, liver and other sites leading to loss of lean mass and organ dysfunction (21). Adipose tissue is pro-inflammatory, and obesity is associated with high baseline C-reactive protein, interleukin-6, low adiponectin and high leptin (7). Fat free mass includes body water, skeletal and smooth muscle mass, and bones.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

Merchant

Seetharaman

et al. 2021

Front. Endocrinol.

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BackgroundBody mass index (BMI) is an inadequate marker of obesity, and cannot distinguish between fat mass, fat free mass and distribution of adipose tissue. The purpose of this study was twofold. First, to assess cross-sectional relationship of BMI with fat mass index (FMI), fat free mass index (FFMI) and ratio of fat mass to fat free mass (FM/FFM). Second, to study the association of FMI, FFMI and FM/FFM with physical function including sarcopenia, and cognition in pre-frail older adults.MethodsCross-sectional study of 191 pre-frail participants ≥ 65 years, 57.1% females. Data was collected on demographics, cognition [Montreal Cognitive Assessment (MoCA)], function, frailty, calf circumference, handgrip strength (HGS), short physical performance battery (SPPB) and gait speed. Body composition was measured using InBody S10. FMI, FFMI and FM/FFM were classified into tertiles (T1, T2, T3) with T1 classified as lowest and T3 highest tertile respectively and stratified by BMI.ResultsHigher FFMI and lower FM/FFM in the high BMI group were associated with better functional outcomes. Prevalence of low muscle mass was higher in the normal BMI group. FMI and FM/FFM were significantly higher in females and FFMI in males with significant gender differences except for FFMI in ≥ 80 years old. Small calf circumference was significantly less prevalent in the highest tertile of FMI, FM/FMI and FFMI. Prevalence of sarcopenic obesity and low physical function (HGS, gait speed and SPPB scores) were significantly higher in the highest FMI and FM/FFM tertile. Highest FFMI tertile group had higher physical function, higher MoCA scores, lower prevalence of sarcopenic obesity and sarcopenia, After adjustment, highest tertile of FFMI was associated with lower odds of sarcopenia especially in the high BMI group. Highest tertile of FM/FFM was associated with higher odds of sarcopenia. Higher BMI was associated with lower odds of sarcopenia.ConclusionFFMI and FM/FFM may be a better predictor of functional outcomes in pre-frail older adults than BMI. Cut-off values for healthy BMI values and role of calf circumference as a screening tool for sarcopenia need to be validated in larger population. Health promotion intervention should focus on FFMI increment.

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“…This has been attributed to induction of suppressor of cytokine signaling-3 (SOCS3) which, by inhibiting JAK/ STAT signaling, impairs IFN response [ 349 ]. Further, decreased TLR3 activation also leads to decreased IFN-1 production [ 350 ]. Increased expression of SOCS3 occurring in viral infection can also result in inhibition of leptin signaling and immune suppression by Treg cells [ 351 ].…”

Section: Why Is Obesity a Risk For Covid-19 ?—Pathways And Molecular ...mentioning

confidence: 99%

Mechanisms contributing to adverse outcomes of COVID-19 in obesity

et al. 2022

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A growing amount of epidemiological data from multiple countries indicate an increased prevalence of obesity, more importantly central obesity, among hospitalized subjects with COVID-19. This suggests that obesity is a major factor contributing to adverse outcome of the disease. As it is a metabolic disorder with dysregulated immune and endocrine function, it is logical that dysfunctional metabolism contributes to the mechanisms behind obesity being a risk factor for adverse outcome in COVID-19. Emerging data suggest that in obese subjects, (a) the molecular mechanisms of viral entry and spread mediated through ACE2 receptor, a multifunctional host cell protein which links to cellular homeostasis mechanisms, are affected. This includes perturbation of the physiological renin-angiotensin system pathway causing pro-inflammatory and pro-thrombotic challenges (b) existent metabolic overload and ER stress-induced UPR pathway make obese subjects vulnerable to severe COVID-19, (c) host cell response is altered involving reprogramming of metabolism and epigenetic mechanisms involving microRNAs in line with changes in obesity, and (d) adiposopathy with altered endocrine, adipokine, and cytokine profile contributes to altered immune cell metabolism, systemic inflammation, and vascular endothelial dysfunction, exacerbating COVID-19 pathology. In this review, we have examined the available literature on the underlying mechanisms contributing to obesity being a risk for adverse outcome in COVID-19.

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Review: Obesity and COVID-19: A Detrimental Intersection

Cited by 27 publications

References 59 publications

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Sleep Deprivation, Immune Suppression and SARS-CoV-2 Infection

Relationship of Fat Mass Index and Fat Free Mass Index With Body Mass Index and Association With Function, Cognition and Sarcopenia in Pre-Frail Older Adults

Mechanisms contributing to adverse outcomes of COVID-19 in obesity

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