Obesity and impaired metabolic health in patients with COVID
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In China, older age (≥65 years) and the presence of comorbidities are associated with a more severe course of COVID-19 in patients infected with the novel coronavirus (SARS-CoV-2). Among the comorbid conditions, the highest fatality rate was found for cardiovascular disease (CVD) (10.5%) and diabetes mellitus (7.3%), followed by chronic respiratory diseases (6.3%), hypertension (6.0%) and cancer (5.6%). A direct endocrine and metabolic link between hypertension and diabetes mellitus and coronavirus infection, which might involve angiotensin-converting enzyme 2, is being discussed.

The Obesity Paradox:
Conversely, an obesity survival paradox has been observed in patients with pneumonia. That is, despite the increased risk of pneumonia and difficulties of intubation and mask ventilation, the risk of death in patients with obesity and pneumonia might be decreased. Potentially counter-balancing effects of obesity might include the more aggressive treatment provided to these patients, their increased metabolic reserve or other unidentified factors. Thus, as a result of a potentially critical role of body weight or adiposity in determining the incidence and severity of pneumonia (and possibly other complications), it is important to collect anthropometric information for patients with COVID-19.

Conclusively, while it is widely recognized that the presence of comorbidities such as hypertension, diabetes mellitus and CVD is associated with a more severe course of COVID-19, obesity has hardly been investigated so far. Obesity is a main risk factor for these comorbidities and more generally for impaired metabolic health (such as dyslipidaemia and insulin resistance) and is also linked to an increased risk of pneumonia. Measurement of anthropometric characteristics and metabolic parameters is crucial to better estimate the risk of complications in patients with COVID-19.

Source: https://www.nature.com/articles/s41574-020-0364-6