Elsevier

Mayo Clinic Proceedings

Volume 95, Issue 7, July 2020, Pages 1445-1453
Mayo Clinic Proceedings

Special article
Obesity and Outcomes in COVID-19: When an Epidemic and Pandemic Collide

https://doi.org/10.1016/j.mayocp.2020.05.006Get rights and content

Abstract

Obesity has reached epidemic proportions in the United States and in much of the westernized world, contributing to considerable morbidity. Several of these obesity-related morbidities are associated with greater risk for death with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 penetrates human cells through direct binding with angiotensin-converting enzyme 2 receptors on the cell surface. Angiotensin-converting enzyme 2 expression in adipose tissue is higher than that in lung tissue, which means that adipose tissue may be vulnerable to COVID-19 infection. Obese patients also have worse outcomes with COVID-19 infection, including respiratory failure, need for mechanical ventilation, and higher mortality. Clinicians need to be more aggressive when treating obese, especially severely obese, patients with COVID-19 infection.

Abbreviations and Acronyms

ACE
angiotensin-converting enzyme
ACEi
angiotensin-converting enzyme inhibitor
AF
atrial fibrillation
Ang II
angiotensin II
ARB
angiotensin receptor blocker
BMI
body mass index
CHD
coronary heart disease
CKD
chronic kidney disease
COVID-19
coronavirus disease 2019
CVD
cardiovascular disease
ET
exercise training
HF
heart failure
HTN
hypertension or hypertensive
MetS
metabolic syndrome
OR
odds ratio
PA
physical activity
RAAS
renin-angiotensin-aldosterone system
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
SNS
sympathetic nervous
T2DM
type 2 diabetes mellitus
VTE
venous thromboembolism

Cited by (0)

Grant Support: F.S.-G. is supported by a postdoctoral contract granted by “Subprograma Atracció de Talent - Contractes Postdoctorals de la Universitat de València.”

Potential Competing Interests: Dr Mehra reports consultancy with Abbott, Janssen, Roivant, Baim Institute for Clinical Research, Leviticus, FineHeart, NupulseCV, Portola, Bayer, Triple Gene, and Mesoblast. The other authors report no competing interests.

View Abstract