RESUMENLa obesidad, enfermedad caracterizada por acumulación excesiva de tejido adiposo, es el factor asociado al mayor índice de severidad en la infección por SARS-CoV-2. Durante la pandemia, tanto investigaciones independientes como del Ministerio de Salud (MINSA-Perú) mostraron correlación entre obesidad y COVID-19. La investigación tiene como objetivo analizar de qué manera la respuesta inmune desregulada en pacientes obesos actúa como agravante de COVID-19. Para ello, se revisó evidencia científica disponible en diferentes bases de datos, tras lo cual se encontró que la respuesta inmune desregulada causada por la obesidad se amplifica al asociarse con COVID-19, ya que potencia la creación de un microambiente inflamatorio local de bajo grado inducido por secreciones de adipocitos disfuncionales. Asimismo, los pacientes obesos presentan mayor susceptibilidad a la infección por SARS-CoV-2 debido a la pérdida gradual de ASC funcionales que perjudica la ciliogénesis, reduciendo así su eliminación; además, el tejido adiposo alterado propicia la sobreexpresión de receptores de proteasas que facilitarán su entrada. El agravamiento del cuadro clínico de COVID-19 se desencadenará en consecuencia de los procesos de disfunción endotelial y disminución de la angiogénesis puesto que, en conjunto, producirán hipoxia, fibrosis e insuficiencia funcional pulmonar. Se concluye que la respuesta inmune desregulada en pacientes obesos está estrechamente relacionada con la morbimortalidad a nivel cardio-metabólico, que conlleva al cuadro clínico severo y en algunos casos, al deceso del paciente infectado. Palabras clave: Obesidad (DeCS), COVID-19 (DeCS), respuesta inmune (DeCS). SUMMARYObesity, a disease characterized by excessive accumulation of adipose tissue, is the factor associated with the highest severity index in SARS-CoV-2 infection. During the pandemic, both independent investigations and the Ministry of Health (MINSA-Peru) showed a correlation between obesity and COVID-19. The research aims to analyze how the dysregulated immune response in obese patients acts as an aggravation of COVID-19. To do this, scientific evidence available in different databases was reviewed, after which it was found that the dysregulated immune response caused by obesity is amplified when associated with COVID-19, since it enhances the creation of a low-grade local inflammatory microenvironment induced by dysfunctional adipocyte secretions. Likewise, obese patients are more susceptible to SARS-CoV-2 infection due to the gradual loss of functional ASC that impairs ciliogenesis, thus reducing their elimination; also, the altered adipose tissue favors the overexpression of protease receptors that will facilitate their entry. The worsening of the clinical picture of COVID-19 will be triggered as a consequence of the processes of endothelial dysfunction and decreased angiogenesis since, together, they will produce hypoxia, fibrosis and pulmonary functional insufficiency. It is concluded that the dysregulated immune response in obese patients is clo...
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