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2 de mar. de 2021 · The increased prevalence of obesity, diabetes, and cardiovascular risk factors in people hospitalized with severe COVID-19 illness has engendered considerable interest in the metabolic aspects of SARS-CoV-2-induced pathophysiology.
- Daniel J. Drucker
- 2021
- Viral Entrance: ACE2 and DPP4
- Endothelial Cell Damage and Thromboinflammation
- Dysregulation of The Immune Response
- Dysregulation of The Raas
- Insulin Resistance Induced Inflammation
- Insulin Resistance, Hyperinsulinemia and Lung Mechanics
- Hyperglycemia and Endocrine Pancreas
The coronavirus entrance into cells is facilitated by its spike protein using ACE2 as an entry receptor, with higher affinity binding. In this process the binding of the spike protein by the cellular serine protease TMPRSS2 is also important, indicating that both ACE2 and TMPRSS2 are key proteins in the process for the virus entrance (Fig. 1a). Th...
It is now well established that ACE2-mediated entry of SARS-CoV-2 into endothelial cells induces inflammation and the generation of a prothrombotic milieu [12,13,14] (Fig. 1b). These alterations in the set of COVID-19 result in increased thrombin production associated with inhibition of fibrinolysis and activation of complement pathways, a cascade ...
Dysregulation of the immune response is a key characteristic of COVID-19, in which there is an increase in cytokine release associated with an attenuation of interferon response, mainly due to T cell lymphodepletion in parallel with a hyperactivations of innate immunity (Fig. 1c). The type I and type II interferon receptors are expressed in immune...
Modulations of the RAAS are another piece of the puzzle of the pathophysiological mechanism of COVID-19. The RAAS can be summarized as a cascade of regulatory peptides, peptidases, and receptors that participate in many homeostatic processes of the body, including blood pressure regulation, fluid and electrolyte balance, vascular permeability, and ...
Although it is well accepted that inflammation in obesity can induce insulin resistance, recent evidence suggests that the opposite is also true, i.e., insulin resistance by itself can also induce inflammation . Insulin resistance in adipose tissue induces macrophage infiltration, developing an inflammatory state. The molecular mechanisms for this ...
Insulin resistance induces dramatic consequences for health, affecting vessels, heart, brain, and kidneys, however the effects of this hormonal resistance on lung function is only marginally known. Previous data has shown that obesity and fat accumulation in the abdomen pushes up the diaphragm and restricts airflow. Reduced lung volumes subsequentl...
Previous data in diabetic patients at hospital admission showed that hyperglycemia was an important predictor of worse outcomes such as ICU admission, mechanical ventilation and death [64, 65]. Similar results were observed in in-hospital glycemic control, i.e., higher blood glucose levels and bad metabolic control were also associated with worse o...
- Andrey Santos, Daniéla Oliveira Magro, Rosana Evangelista-Poderoso, Mario José Abdalla Saad
- 2021
10 de jan. de 2022 · Obesity, cardiometabolic dysfunction and type 2 diabetes are now well accepted to be substantial risk factors for poor outcomes (intensive hospital stays, mechanical ventilation and death) following SARS-CoV-2 infection.
- 10.1016/j.metabol.2021.155121
- 2022/03
- Metabolism. 2022 Mar; 128: 155121.
9 de dez. de 2022 · Obesity and diabetes are established risk factors for severe SARS-CoV-2 outcomes, but less is known about their impact on susceptibility to COVID-19 infection and general symptom severity.
6 de dez. de 2021 · Obesity and impaired metabolic health are important risk factors for severe COVID-19. Novel data indicate that these risk factors might also promote vaccine-breakthrough SARS-CoV-2 infections...
2 de nov. de 2022 · Obesity is an important risk factor for severe COVID-19 and, possibly, for breakthrough SARS-CoV-2 infections in fully vaccinated people. Novel findings highlight how SARS-CoV-2 infects...
17 de set. de 2020 · There are many features of diabetes and obesity that may accentuate the clinical response to SARS-CoV-2 infection: including an impaired immune response, an atherothrombotic state, accumulation of advanced glycation end products and a chronic inflammatory state.
