Low-grade inflammation, CoVID-19, and obesity: clinical aspect and molecular insights in childhood and adulthood

Abstract

The new 2019 coronavirus 19 disease (CoVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a serious threat to health systems. As a global health problem, this pandemic poses a huge threat to people and is responsible for significant morbidity and mortality worldwide. On the other hand, obesity has also reached epidemic proportions and poses another challenge to the healthcare system. There is increasing evidence of a strong association between obesity and CoVID-19 disease, but the mechanisms underlying the link between the two remain unclear and the role of obesity also remains to be elucidated. In particular obesity-related low-grade inflammation has been hypothesized as the Achille’s heel that could predispose subjects with obesity to a more severe CoVID-19 compared to subjects with normal weight. Hence, we summarized recent evidence on the role of low-grade inflammation in clinical aspects of CoVID-19 in subjects with obesity in both childhood and adulthood. Further, we provide molecular insights to explain this link.

Immunogenicity of three doses of anti-SARS-CoV-2 BNT162b2 vaccine in psoriasis patients treated with biologics

“…The combination of these phenomena could explain both the poor prognosis of obese patients in COVID 19 infection, but also an abnormal response to the vaccine ( 76 , 77 ). There is ample evidence to support a lack of efficacy in the antibody response of obese people to common vaccines such as influenza, rabies and hepatitis B ( 78 , 79 ).…”

“…Importantly, methotrexate negatively affected the antibody response, although firm conclusions around its role as a single agent cannot be drawn, as it was used only in four patients in combination with infliximab and discontinued for 1 week after the vaccination. Nevertheless, methotrexate impairment of the antibody response to vaccines has been widely demonstrated and temporary discontinuation during vaccination is recommended by most scientific societies (67)(68)(69)(70)(71)(72)(73)(74)(75)(76).…”

Obesity as a Risk Factor for Severe COVID-19 in Hospitalized Patients: Epidemiology and Potential Mechanisms

“…In addition, an increase in circulating platelet-derived microparticles and deregulation of fibrinolytic markers in obese patients have been previously reported, positively correlated with BMI and excess adipose tissue, which generates platelet activation and dysregulation of hemostasis [ 57 ]. Based on this, the increase in inflammatory cytokines in COVID-19, including IL-1α expressed in platelets, monocytes, and endothelial cells under proinflammatory conditions, constitutes a link between the inflammatory response and activation of the coagulation system [ 58 ]. Finally, obesity is characterized by the presence of oxidative stress, which induces platelet dysfunction.…”

Molecular and pro-inflammatory aspects of COVID-19: The impact on cardiometabolic health

“…A well-studied aspect of SARS-CoV2 infection is the dysregulated immune response that impairs T-cell-mediated immunity and produces abnormal levels of proinflammatory cytokines. Both children with obesity [36] and adult patients [37] are exposed to an increased risk of pneumonia and worse outcomes in COVID-19 [38] due to the enhanced secretion of proinflammatory cytokines that are involved in chronic low-grade inflammation [39] . Chronic inflammation and impaired T-cell immunity could be considered the key processes linking obesity and COVID-19.…”