SARS-CoV-2 infection and obesity: Common inflammatory and metabolic aspects

Konstantinos Michalakis, Ioannis Ilias, Konstantinos Michalakis, Ioannis Ilias

Abstract

Backround and aims: According to the World Obesity Federation, "obesity-related conditions seem to worsen the effect of Covid-19 (SARS-CoV-2)"; additionally the Centres for Disease Control and Prevention reported that "people with heart disease and diabetes are at higher risk of SARS-CoV-2 complications and that severe obesity poses a higher risk for severe illness". Recent reports have shown elevated levels of cytokines due to increased inflammation in patients with SARS-CoV-2 disease. On the other hand, obesity represents a state of low-grade inflammation, with various inflammatory products directly excreted by adipose tissue. In this concise report we aimed to assess common elements of obesity and SARS-CoV-2 infection.

Methods: Pubmed search on obesity and SARS-CoV-2 infection.

Results: We present "mechanistic" obesity-related problems that aggravate SARS-CoV-2 infection as well as tentative inflammatory/metabolic links between these diseases.

Conclusion: Obesity and SARS-CoV-2 share common elements of the inflammatory process (and possibly also metabolic disturbances), exacerbating SARS-CoV-2 infection in the obese.

Keywords: Coronavirus; Glucose; Human; Infection; Inflammation; Obesity.

Conflict of interest statement

Declaration of competing interest The authors do not have any conflicts of interest and sources of funding to declare. The authors received no funding for this work.

Copyright © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
Selected metabolic pathways for obesity and SARS-CoV-2 infection; their common elements are shown in grey boxes. In obesity, resistance to leptin (along with resistin) leads to insulin resistance (both in the brain and in peripheral tissues) and eventually to hyperglycemia and T2DM. Moreover, adipose tissue releases ATG, which, via ACE is converted to AT II and increases blood pressure. SARS-CoV-2 attaches to cells via ACE2 and may provoke hyperglycemia (see text for more details); FFA: free fatty acids, ATG: angiotensinogen, ACE: angiotensin converting enzyme, AT II: angiotensin II, AT 1–7: angiotensin 1-7 (vasodilatory), NO: Nitric Oxide, T2DM: type 2 diabetes mellitus, ACE2: angiotensin converting enzyme 2, ∗: is usually upregulated in subjects with hypertension on ACE-inhibitors and AT receptor blockers (ARB), ∗∗hyperglycemia has been reported in patients with SARS-CoV-2 infection – the specific mechanisms have not been elucidated.

References

    1. World Health Organisation (WHO) Coronavirus disease (Covid-19) pandemic.
    1. World Health Organisation (WHO) Obesity.
    1. Michalakis K., Goulis D.G., Vazaiou A., Mintziori G., Polymeris A., Abrahamian-Michalakis A. Obesity in the ageing man. Metabolism. 2013;62:1341–1349.
    1. Centres for Disease Control and Prevention (CDC) Coronavirus (Covid-19)
    1. Sun Y., Wang Q., Yang G., Lin C., Zhang Y., Yang P. Weight and prognosis for influenza A(H1N1)pdm09 infection during the pandemic period between 2009 and 2011: a systematic review of observational studies with meta-analysis. Inf Disp. 2016 Nov-Dec;48(11–12):813–822. doi: 10.1080/23744235.2016.1201721. Epub 2016 Jul 6.
    1. Neidich S.D., Green W.D., Rebeles J., Karlsson E.A., Schultz-Cherry S., Noah T.L. Increased risk of influenza among vaccinated adults who are obese. Int J Obes. 2017;41:1324–1330.
    1. Ryan D.H., Ravussin E., Heymsfield S. COVID 19 and the patient with obesity - the editors speak out. Obesity. 2020 Apr 1 doi: 10.1002/oby.22808.
    1. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–513.
    1. Ilias I., Zabuliene L. Hyperglycemia and the novel Covid-19 infection: possible pathophysiologic mechanisms. Med Hypotheses. 2020;139 109699.
    1. Zhang X., Wu K., Wang D., Yue X., Song D., Zhu Y. Nucleocapsid protein of SARS-CoV activates interleukin-6 expression. through cellular transcription factor NF-κB. Virology. 2007;365:324–335.
    1. Fang X., Gao J., Zheng H., Li B., Kong L., Zhang Y. The membrane protein of SARS-CoV suppresses NF-kappaB activation. J Med Virol. 2007;79:1431–1439.
    1. Canton J., Fehr A.R., Fernandez-Delgado R., Gutierrez-Alvarez F.J., Sanchez-Aparicio M.T., García-Sastre A. MERS-CoV 4b protein interferes with the NF-κB-dependent innate immune response during infection. PLoS Pathog. 2018;14 e1006838.
    1. Ulhaq Z.S., Soraya G.V. Interleukin-6 as a potential biomarker of COVID-19 progression. Med Maladies Infect. 2020 Apr 4 doi: 10.1016/j.medmal.2020.04.002. pii: S0399-077X(20)30088-3.
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
    1. Divella R., De Luca R., Abbate I., Naglieri E., Daniele A. Obesity and cancer: the role of adipose tissue and adipo-cytokines-induced chronic inflammation. J Canc. 2016;7:2346–2359.
    1. Michalakis K., Venihaki M., Mantzoros C., Vazaiou A., Ilias I., Gryparis A. In prostate cancer, low adiponectin levels are not associated with insulin resistance. Eur J Clin Invest. 2015;45:572–578.
    1. Ellulu M.S., Patimah I., Khaza’ai H., Rahmat A., Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13:851–863.
    1. Stone T.W., McPherson M., Gail Darlington L. Obesity and cancer: existing and new hypotheses for a causal connection. EBioMedicine. 2018;30:14–28.
    1. Zhang A.J., To K.K., Li C., Lau C.C., Poon V.K., Chan C.C. Leptin mediates the pathogenesisiof severe 2009 pandemic influenza A (H1N1) infection associated with cytokine dysregulation in mice with diet-induced obesity. J Infect Dis. 2013;207:1270–1280.
    1. Lelis D.F., Freitas D.F., Machado A.S., Crespo T.S., Santos S.H.S. Angiotensin-(1-7), adipokines and inflammation. Metabolism. 2019;95:36–45.
    1. Danser A.H.J., Epstein M., Batlle D. Renin-angiotensin system blockers and the COVID-19 pandemic: at present there is No evidence to abandon renin-angiotensin system blockers. Hypertension. 2020 doi: 10.1161/HYPERTENSIONAHA.120.15082.

Source: PubMed

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