Differential association between inflammatory cytokines and multiorgan dysfunction in COVID-19 patients with obesity

Abstract

To investigate the mechanisms underlying the SARS-CoV-2 infection severity observed in patients with obesity, we performed a prospective study of 51 patients evaluating the impact of multiple immune parameters during 2 weeks after admission, on vital organs’ functions according to body mass index (BMI) categories. High-dimensional flow cytometric characterization of immune cell subsets was performed at admission, 30 systemic cytokines/chemokines levels were sequentially measured, thirteen endothelial markers were determined at admission and at the zenith of the cytokines. Computed tomography scans on admission were quantified for lung damage and hepatic steatosis (n = 23). Abnormal BMI (> 25) observed in 72.6% of patients, was associated with a higher rate of intensive care unit hospitalization (p = 0.044). SARS-CoV-2 RNAaemia, peripheral immune cell subsets and cytokines/chemokines were similar among BMI groups. A significant association between inflammatory cytokines and liver, renal, and endothelial dysfunctions was observed only in patients with obesity (BMI > 30). In contrast, early signs of lung damage (ground-glass opacity) correlated with Th1/M1/inflammatory cytokines only in normal weight patients. Later lesions of pulmonary consolidation correlated with BMI but were independent of cytokine levels. Our study reveals distinct physiopathological mechanisms associated with SARS-CoV-2 infection in patients with obesity that may have important clinical implications.

Obesity is associated with a distinct innate immune phenotype in severe COVID-19 patients

“…Finally, red blood cell parameters were strongly associated with both LD and HD neutrophils expressing PD-L1 in patients with obesity. Consistently, there is a higher risk for endothelial damage and related complications in this population 37 , and neutrophils are suggested to be involved in coagulation and phagocytosis of red blood cells in COVID-19 35,38 . As we were not able to analyze endothelial functions, LD and HD neutrophils should be further explored in future studies, especially in populations with higher cardiovascular risk than individuals with obesity.…”

Correlation between Antioxidant and Anti-Osteoporotic Activities of Shilajit Loaded into Chitosan Nanoparticles and Their Effects on Osteoporosis in Rats

“…The hepatic inflammation accompanied by an increase in IL-6 levels was an inflammatory marker. Inflammatory responses were orchestrated and affected by cytokines and chemokines, which are when decreased should diminish overall inflammation [ 50 , 51 ]. Shilajit treatment showed overall improvement in the pathological changes observed in the liver and kidney.…”

Cardiovascular Morbidity and Mortality in COVID-19: A Multicenter Retrospective Analysis

“…Morbidly obese (BMI ≥40) patients had a greater risk for PE as well. The prothrombotic attributes of cancer are likely potentiating COVID-19's innate upregulation of the coagulation cascade [9,19,22,25]. Moreover, only 207 patients received full systemic anticoagulation which may not provide sufficient statistical power to draw a statistical conclusion.…”

“…These risk factors include ethnicity (i.e Hispanic, African American, etc), age, smoking, diabetes, hypertension, heart failure, obesity, chronic kidney disease, and cancer [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Further, patients infected with COVID-19 can experience a wide gamut of sequalae ranging from transient loss of smell and taste to a life-threatening cytokine storm causing multiorgan failure [19].…”