COVID-19 and Metabolic Syndrome: NF-κB Activation. Crossroads

Guisado-Vasco, Pablo; Cano-Megías, Marta; Rodríguez-López, Margarita; de-Luna-Boquera, Iris Mercedes; Carnevali-Ruiz, Daniel

doi:10.1016/j.tem.2020.08.004

Cited by 21 publications

(16 citation statements)

References 15 publications

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“…The finding that risk for severe COVID-19–associated illness increases with higher BMI suggests that progressively intensive management of COVID-19 might be needed for patients with more severe obesity. This finding also supports the hypothesis that inflammation from excess adiposity might be a factor in the severity of COVID-19–associated illness ( 3 , 8 ). The positive association found between underweight and hospitalization risk could be explained by uncaptured underlying medical conditions or impairments in essential nutrient availability and immune response ( 9 ).…”

Section: Discussionsupporting

confidence: 87%

Body Mass Index and Risk for COVID-19–Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death — United States, March–December 2020

Kompaniyets¹,

Goodman²,

Belay³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

372

301

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On March 8, 2021, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). Obesity* is a recognized risk factor for severe COVID-19 (1,2), possibly related to chronic inflammation that disrupts immune and thrombogenic responses to pathogens (3) as well as to impaired lung function from excess weight (4). Obesity is a common metabolic disease, affecting 42.4% of U.S. adults (5), and is a risk factor for other chronic diseases, including type 2 diabetes, heart disease, and some cancers. † The Advisory Committee on Immunization Practices considers obesity to be a high-risk medical condition for COVID-19 vaccine prioritization (6). Using data from the Premier Healthcare Database Special COVID-19 Release (PHD-SR), § CDC assessed the association between body mass index (BMI) and risk for severe COVID-19 outcomes (i.e., hospitalization, intensive care unit [ICU] or stepdown unit admission, invasive mechanical ventilation, and death). Among 148,494 adults who received a COVID-19 diagnosis during an emergency department (ED) or inpatient visit at 238 U.S. hospitals during March-December 2020, 28.3% had overweight and 50.8% had obesity. Overweight and obesity were risk factors for invasive mechanical ventilation, and obesity was a risk factor for hospitalization and death, particularly among adults aged <65 years. Risks for hospitalization, ICU admission, and death were lowest among patients with BMIs of 24.2 kg/m 2 , 25.9 kg/m 2 , and 23.7 kg/m 2 , respectively, and then increased sharply with higher BMIs. Risk for invasive mechanical ventilation increased over the full range of BMIs, from 15 kg/m 2 to 60 kg/m 2. As clinicians develop care plans for COVID-19 patients, they should consider the risk for severe outcomes in patients with higher BMIs, especially for those with severe obesity. These findings highlight the clinical and public health implications of higher BMIs, including the need for intensive COVID-19 illness management as obesity severity increases, promotion of COVID-19 prevention strategies including * Obesity (body mass index ≥30 kg/m 2) is frequently categorized into three categories: class 1 (30.0-34.9 kg/m 2), class 2 (35.0-39.9 kg/m 2), and class 3 (≥40 kg/m 2). Class 3 obesity is sometimes referred to as "extreme" or "severe" obesity.

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Section: Discussionsupporting

confidence: 87%

Body Mass Index and Risk for COVID-19–Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death — United States, March–December 2020

Kompaniyets¹,

Goodman²,

Belay³

et al. 2021

MMWR Morb. Mortal. Wkly. Rep.

372

301

View full text Add to dashboard Cite

show abstract

“…Hypertension and disorders of lipid metabolism (the most prevalent conditions), and obesity and diabetes with complication (strong risk factors for death, IMV, and ICU admission) are associated with well-described hormonal and inflammatory pathways, also previously shown to be risk factors for severe COVID-19 illness ( 16 ). High baseline prevalence of obesity and diabetes, combined with their association with severe COVID-19 illness, suggest that these 2 conditions could have an outsized impact on the population with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021

et al. 2021

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In this cross-sectional study of 540,667 adult hospitalized patients with COVID-19, 94.9% had at least 1 underlying medical condition. Hypertension and disorders of lipid metabolism were the most frequent, whereas obesity, diabetes with complication, anxiety disorders, and the total number of conditions were the strongest risk factors for severe COVID-19 illness. What are the implications for public health practice?Preventing COVID-19 in populations with these underlying conditions and multiple conditions should remain a public health priority, with targeted mitigation efforts and ensuring high uptake of vaccine, when available, in these individuals and their close contacts.

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“…Recent reports have indicated that the NF-κB pathway acts as a central signaling pathway for the SARS-CoV-2 infection-induced pro-inflammatory cytokine/chemokine response and plays a central role in the severity and lethality of COVID-19 [ 41 , 42 ]. Accordingly, chronically pre-elevated NF-κB activity levels in diabetic people may act additively or synergistically, increasing SARS-CoV-2-triggered NF-κB activation [ 42 ] and resulting in massive cytokine and chemokine release and activation marker and adhesion molecule expression [ 74 ].…”

Section: Reasons For Lower Mortality and Morbidity Of Covid-19 In Africa Compared To Other Regions Of The Worldmentioning

confidence: 99%

COVID-19: Mechanistic Model of the African Paradox Supports the Central Role of the NF-κB Pathway

Kircheis¹,

Schuster²,

Planz

2021

Viruses

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The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has expanded into a global pandemic, with more than 220 million affected persons and almost 4.6 million deaths by 8 September 2021. In particular, Europe and the Americas have been heavily affected by high infection and death rates. In contrast, much lower infection rates and mortality have been reported generally in Africa, particularly in the sub-Saharan region (with the exception of the Southern Africa region). There are different hypotheses for this African paradox, including less testing, the young age of the population, genetic disposition, and behavioral and epidemiological factors. In the present review, we address different immunological factors and their correlation with genetic factors, pre-existing immune status, and differences in cytokine induction patterns. We also focus on epidemiological factors, such as specific medication coverage, helminth distribution, and malaria endemics in the sub-Saharan region. An analysis combining different factors is presented that highlights the central role of the NF-ĸB signaling pathway in the African paradox. Importantly, insights into the interplay of different factors with the underlying immune pathological mechanisms for COVID-19 can provide a better understanding of the disease and the development of new targets for more efficient treatment strategies.

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COVID-19 and Metabolic Syndrome: NF-κB Activation. Crossroads

Cited by 21 publications

References 15 publications

Body Mass Index and Risk for COVID-19–Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death — United States, March–December 2020

Body Mass Index and Risk for COVID-19–Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death — United States, March–December 2020

Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021

COVID-19: Mechanistic Model of the African Paradox Supports the Central Role of the NF-κB Pathway

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