Long COVID: A New Challenge for Prevention of Obesity in Women

Abstract

The long COVID affects individuals that do not recover for several weeks or months following the onset of symptoms of COVID-19. Obesity could play a role in the long COVID syndrome. During the pandemic, various factors contributed greatly to aggravating obesity in women leading to a pro-inflammatory and prothrombotic status. The present commentary explores the relationship between long COVID and obesity in women.

Cardiovascular prevention in women: an update by the Italian Society of Cardiology working group on ‘Prevention, hypertension and peripheral disease’

“…In premenopause and menopause, there is a significant increase in total and intra-abdominal fat mass, which is associated with the so-called ‘sarcopenic obesity’ linked to the decrease in muscle mass 22–25 . These two conditions of excess fat accumulation are related to several chronic diseases, including CVD, diabetes, hypertension and some types of cancer 26,27 …”

“…21 In premenopause and menopause, there is a significant increase in total and intra-abdominal fat mass, which is associated with the so-called 'sarcopenic obesity' linked to the decrease in muscle mass. [22][23][24][25] These two conditions of excess fat accumulation are related to several chronic diseases, including CVD, diabetes, hypertension and some types of cancer. 26,27 A strong association between obesity and invasive breast cancer has been described; the relationship is mediated by an increase in oestrogen production by adipocytes, inflammation and insulin resistance in peripheral tissues.…”

Vascular “Long COVID”: A New Vessel Disease?

“…46,47,48,49 Moreover, the same endothelial damage, associated with an abnormal immune-inflammatory response, can involve normal arterial walls, where circulating immune-inflammatory cells, neutrophils, lymphocytes, and macrophages, favor dispersion of smooth muscle cells from the medial layer, and their migration to intima, attempting to replace the lost endothelial cells. 2-33,50-52 In a hyper-coagulant milieu, both these factors directly lead to vascular thromboses, mainly venous, but also arterial (Figure 2). In most cases, all the elements of Virchow’s triad are fulfilled: endothelial damage, hyper-coagulant state, and the altered blood dynamics, consisting in partial obstructions and/or aneurysms.…”

“…Long COVID (defined as occurring 12 weeks after the original infection) is characterized by symptoms lasting for many months in subjects who have had a severe, moderate, or mild form of COVID-19. [1][2][3][4] The most common symptoms are persistent fatigue, shortness of breath, tachycardia and palpitations, anosmia, muscle weakness, brain fog, headache, vomiting and nausea, fever, and skin rash. 3,5 The persistence of COVID-19 symptoms has been reported in several studies.…”

The Impact of Physical Activity and Inactivity on Cardiovascular Risk across Women’s Lifespan: An Updated Review

“…Recently, the “Long COVID syndrome” or “post-acute sequelae of COVID-19” (PASC) is emerging in clinical practice. This condition occurs 3 or more weeks after the original infection and is characterized by symptoms lasting for at least 2 months, with no other explanation, in subjects who have had a severe, moderate, or mild form of COVID-19, mainly females [ 168 , 169 , 170 , 171 , 172 ]. The persistence of SARS-CoV-2 symptoms severely affects functional and emotional status, as well as leisure-time PA, especially in the female population, limiting PA participation and decreasing both CV health and quality of life [ 173 , 174 , 175 ].…”