Abstract：With corona virus disease 2019 (COVID-19) raging around the world, healthcare systems in many countries are under severe strain due to the lack of an effective vaccine or antiviral therapy. COVID-19 is mainly activated by angiotensin converting enzyme-2 (ACE-2) in human, so ACE-2 is the key receptor for severe acute respiratory syndrome coronavirus 2 to enter host cells. The expression level of ACE-2 in adipose tissues is higher than that in lung tissues, which may increase the susceptibility of obese patients to the virus. Chronic low-grade inflammation, vitamin D deficiency and intestinal flora imbalance associated with obesity can weaken the immune response, making the immune system more susceptible to infection and less responsive to vaccines, antivirals and antibiotics. Chronic inflammation and impaired fibrinolysis caused by obesity increase the risk of thrombosis, which may lead to deteriorating lung damage and patient deaths. Obesity-related complications such as dyslipidemia, type 2 diabetes, hypertension, and cardiovascular diseases may be risk factors for complications in obese COVID-19 patients. Obese patients commonly develop hypoventilation and sleep apnea syndromes, which eventually leads to hypoxemia and pulmonary hypertension. In addition, severe obese patients face significant management challenges in ventilator support, vascular access, and management of bedsore skin ruptures. Therefore, obesity may be a high risk factor for COVID-19 infection and severity. However, some COVID-19 cohort studies suggested that the obesity rate of COVID-19 patients is usually no higher than that of the general population, so obesity may only be an accompanying factor for COVID-19 infection. In addition, studies have shown that compared with normal weight people, obese patients have a lower mortality rate after acute respiratory distress syndrome, so moderate obesity may also improve survival in critically ill patients. Based on this, the review mainly aims to discuss the progress and potential mechanisms of COVID-19 susceptibility in obese patients.
彭佳佳, 张利莉. 肥胖与新型冠状病毒肺炎病毒:易感？伴随？[J]. 中国生物化学与分子生物学报, 2021, 37(10): 1314-1318.
PENG Jia-Jia, ZHANG Li-Li. Obesity:a Facilitator or a Bystander for COVID-19？. Chinese Journal of Biochemistry and Molecular Biol, 2021, 37(10): 1314-1318.
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