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COVID-19 infection and body weight: A deleterious liaison in a J-curve relationship.
Manolis, Antonis S; Manolis, Antonis A; Manolis, Theodora A; Apostolaki, Naomi E; Melita, Helen.
  • Manolis AS; Athens University School of Medicine, Athens, Greece. Electronic address: asm@otenet.gr.
  • Manolis AA; Patras University School of Medicine, Patras, Greece.
  • Manolis TA; Aghia Sofia University Hospital, Athens, Greece.
  • Apostolaki NE; University of Bristol, Bristol, UK.
  • Melita H; Onassis Cardiac Surgery Center, Athens, Greece.
Obes Res Clin Pract ; 15(6): 523-535, 2021.
Article in English | MEDLINE | ID: covidwho-1525912
ABSTRACT
During the course of the COVID-19 pandemic, obesity has been shown to be an independent risk factor for high morbidity and mortality. Obesity confers poor outcomes in younger (<60 years) patients, an age-group considered low-risk for complications, a privilege that is negated by obesity. Findings are consistent, the higher the body mass index (BMI) the worse the outcomes. Ectopic (visceral) obesity also promotes proinflammatory, prothrombotic, and vasoconstrictive states, thus enhancing the deleterious effects of COVID-19 disease. Less, albeit robust, evidence also exists for a higher risk of COVID-19 infection incurred with underweight. Thus, the relationship of COVID-19 and BMI has a J-curve pattern, where patients with both overweight/obesity and underweight are more susceptible to the ailments of COVID-19. The pathophysiology underlying this link is multifactorial, mostly relating to the inflammatory state characterizing obesity, the impaired immune response to infectious agents coupled with increased viral load, the overexpression in adipose tissue of the receptors and proteases for viral entry, an increased sympathetic activity, limited cardiorespiratory reserve, a prothrombotic milieu, and the associated comorbidities. All these issues are herein reviewed, the results of large studies and meta-analyses are tabulated and the pathogenetic mechanisms and the BMI relationship with COVID-19 are pictorially illustrated.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Reviews Limits: Humans Language: English Journal: Obes Res Clin Pract Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Prognostic study / Reviews Limits: Humans Language: English Journal: Obes Res Clin Pract Year: 2021 Document Type: Article