Hypertension, Diabetes and Obesity, Major Risk Factors for Death in Patients with COVID-19 in Mexico

Escobedo, Jorge; Rascón-Pacheco, Ramón Alberto; Ascencio-Montiel, Iván de Jesús; González–Figueroa, Evangelina; Fernández-Gárate, José Esteban; Medina-Gómez, Oswaldo Sinoe; Borja-Bustamante, Patricia; Santillán-Oropeza, Juan Anwar; Borja-Aburto, Víctor Hugo

doi:10.1016/j.arcmed.2020.12.002

Cited by 128 publications

(131 citation statements)

References 29 publications

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“…The results of our study are in line with previous reports linking obesity and individual components of metabolic health with poor COVID-19 outcomes and death (1,5,7,10,12,18,37). In particular, the fact that waist circumference was related to COVID-19 mortality is consistent with a study showing that visceral adipose tissue is significantly related to the risk of admission to an intensive care unit in COVID-19 patients (38).…”

Section: Discussionsupporting

confidence: 92%

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Poor Metabolic Health Increases COVID-19-Related Mortality in the UK Biobank Sample

Morys

2021

Front. Endocrinol.

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Previous studies link obesity and components of metabolic health, such as hypertension or inflammation, to increased hospitalizations and mortality of patients with COVID-19. Here, in two overlapping samples of over 1,000 individuals from the UK Biobank we investigate whether metabolic health as measured by waist circumference, dyslipidemia, hypertension, type 2 diabetes, and systemic inflammation is related to increased COVID-19 infection and mortality rate. Using logistic regression and controlling for confounding variables such as socioeconomic status, age, sex or ethnicity, we find that individuals with worse metabolic health (measured on average eleven years prior to 2020) have an increased risk for COVID-19-related death (adjusted odds ratio: 1.75). We also find that specific factors contributing to increased mortality are increased serum glucose levels, systolic blood pressure and waist circumference.

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Section: Discussionsupporting

confidence: 92%

“…Since the beginning of the COVID-19 pandemic, mounting evidence supports an association between obesity and poor outcomes (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). The association holds for both obesity and obesityassociated metabolic healthhypertension, diabetes, dyslipidemia, and systemic inflammation (13).…”

Section: Introductionmentioning

confidence: 99%

Poor Metabolic Health Increases COVID-19-Related Mortality in the UK Biobank Sample

Morys

2021

Front. Endocrinol.

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“…Most studies investigating this association used BMI categories as the predictor variable [24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Four cross-sectional studies did not specify the used classification of obesity [38][39][40][41] presumably using the WHO guidelines defining obesity as BMI of 30 or higher. Outcome variables included: hospitalization [36,38,42], ICU admission [31,35,37,38,[43][44][45], intubation [24,25,29,37,38], invasive mechanical ventilation [26,31,34], disease severity [27,28,30,33] and death [24][25][26][27][28][29]32,[38]…”

Section: Obesity and Covid-19 Disease Severitymentioning

confidence: 99%

“…Four cross-sectional studies did not specify the used classification of obesity [38][39][40][41] presumably using the WHO guidelines defining obesity as BMI of 30 or higher. Outcome variables included: hospitalization [36,38,42], ICU admission [31,35,37,38,[43][44][45], intubation [24,25,29,37,38], invasive mechanical ventilation [26,31,34], disease severity [27,28,30,33] and death [24][25][26][27][28][29]32,[38][39][40][41]. Of the eleven studies investigating the association between BMI and mortality in hospitalized COVID-19 patients, ten studies observed an increased mortality rate in patients that were overweight (BMI ≥ 25 to <30) [24,32], or suffering from obesity (BMI ≥ 30) [25,29,[38][39][40][41], or severe obesity (BMI ≥ 35) [26,…”

Section: Obesity and Covid-19 Disease Severitymentioning

confidence: 99%

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Demeulemeester¹,

Punder²,

Heijningen³

et al. 2021

Cells

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Emerging data suggest that obesity is a major risk factor for the progression of major complications such as acute respiratory distress syndrome (ARDS), cytokine storm and coagulopathy in COVID-19. Understanding the mechanisms underlying the link between obesity and disease severity as a result of SARS-CoV-2 infection is crucial for the development of new therapeutic interventions and preventive measures in this high-risk group. We propose that multiple features of obesity contribute to the prevalence of severe COVID-19 and complications. First, viral entry can be facilitated by the upregulation of viral entry receptors, like angiotensin-converting enzyme 2 (ACE2), among others. Second, obesity-induced chronic inflammation and disruptions of insulin and leptin signaling can result in impaired viral clearance and a disproportionate or hyper-inflammatory response, which together with elevated ferritin levels can be a direct cause for ARDS and cytokine storm. Third, the negative consequences of obesity on blood coagulation can contribute to the progression of thrombus formation and hemorrhage. In this review we first summarize clinical findings on the relationship between obesity and COVID-19 disease severity and then further discuss potential mechanisms that could explain the risk for major complications in patients suffering from obesity.

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“…Certain comorbidities have been associated with more severe COVID-19 symptoms and worse disease prognosis; therefore, understanding the underlying mechanisms for disease progression, including innate and adaptive immune responses, is of utmost importance to protect vulnerable individuals [6,7]. Furthermore, both differences in gender and ethnicity may influence disease susceptibility and mortality [8].…”

Section: Introductionmentioning

confidence: 99%

Age, Disease Severity and Ethnicity Influence Humoral Responses in a Multi-Ethnic COVID-19 Cohort

Smith

Abdesselem

Mullins

et al. 2021

Viruses

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The COVID-19 pandemic has affected all individuals across the globe in some way. Despite large numbers of reported seroprevalence studies, there remains a limited understanding of how the magnitude and epitope utilization of the humoral immune response to SARS-CoV-2 viral anti-gens varies within populations following natural infection. Here, we designed a quantitative, multi-epitope protein microarray comprising various nucleocapsid protein structural motifs, including two structural domains and three intrinsically disordered regions. Quantitative data from the microarray provided complete differentiation between cases and pre-pandemic controls (100% sensitivity and specificity) in a case-control cohort (n = 100). We then assessed the influence of disease severity, age, and ethnicity on the strength and breadth of the humoral response in a multi-ethnic cohort (n = 138). As expected, patients with severe disease showed significantly higher antibody titers and interestingly also had significantly broader epitope coverage. A significant increase in antibody titer and epitope coverage was observed with increasing age, in both mild and severe disease, which is promising for vaccine efficacy in older individuals. Additionally, we observed significant differences in the breadth and strength of the humoral immune response in relation to ethnicity, which may reflect differences in genetic and lifestyle factors. Furthermore, our data enabled localization of the immuno-dominant epitope to the C-terminal structural domain of the viral nucleocapsid protein in two independent cohorts. Overall, we have designed, validated, and tested an advanced serological assay that enables accurate quantitation of the humoral response post natural infection and that has revealed unexpected differences in the magnitude and epitope utilization within a population.

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Hypertension, Diabetes and Obesity, Major Risk Factors for Death in Patients with COVID-19 in Mexico

Cited by 128 publications

References 29 publications

Poor Metabolic Health Increases COVID-19-Related Mortality in the UK Biobank Sample

Poor Metabolic Health Increases COVID-19-Related Mortality in the UK Biobank Sample

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Age, Disease Severity and Ethnicity Influence Humoral Responses in a Multi-Ethnic COVID-19 Cohort

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