Review Special Issues

Metabolic syndrome and COVID-19

  • Received: 22 June 2020 Accepted: 16 July 2020 Published: 23 July 2020
  • At the end of last year, a new strain of coronavirus emerged in China, which was called SARS-CoV-2. The virus quickly spread throughout the world, reaching pandemic proportions, and is now considered a worldwide public health emergency. In line with this, several studies aimed to postulate and elucidate possible risk factors involved not only in the genesis of coronavirus disease 2019 (COVID-19) but also in the susceptibility and severity of the condition. Among the most reported elements in patients with a more critical clinical scenario and adverse outcomes is metabolic syndrome (MS), a condition consisting of chronic diseases such as obesity, type 2 diabetes mellitus, dyslipidemia, and systemic arterial hypertension. In this light, this work aims to build a descriptive review of the relationship between the factors inherent to MS and COVID-19, in order to better clarify the mechanisms belonging to this association. Resistance to the action of insulin caused by centripetal obesity is permeated by an environment abundant in pro-inflammatory cytokines, which favors the immune imbalance, leading to the modulation of dysfunctional and inefficient responses. Besides, it is important to mention the overlapping of inflammatory secretory patterns of MS with the cytokine storm of COVID-19, leading to a worse prognosis. SARS-CoV-2 and arterial hypertension share pathways through a common enzyme: ACE2, widely expressed in the respiratory epithelium and belonging to the pressure regulation cascade. However, dyslipidemia promotes higher morbidity and mortality through increased cardiovascular risk due to thrombotic events. In short, MS represents a critical element to be considered through association with COVID-19, since it interferes in greater severity and mortality through several factors.

    Citation: Júlia Novaes Matias, Gyovanna Sorrentino dos Santos Campanari, Gabriela Achete de Souza, Vinícius Marinho Lima, Ricardo José Tofano, Claudia Rucco Penteado Detregiachi, Sandra M. Barbalho. Metabolic syndrome and COVID-19[J]. AIMS Bioengineering, 2020, 7(4): 242-253. doi: 10.3934/bioeng.2020021

    Related Papers:

  • At the end of last year, a new strain of coronavirus emerged in China, which was called SARS-CoV-2. The virus quickly spread throughout the world, reaching pandemic proportions, and is now considered a worldwide public health emergency. In line with this, several studies aimed to postulate and elucidate possible risk factors involved not only in the genesis of coronavirus disease 2019 (COVID-19) but also in the susceptibility and severity of the condition. Among the most reported elements in patients with a more critical clinical scenario and adverse outcomes is metabolic syndrome (MS), a condition consisting of chronic diseases such as obesity, type 2 diabetes mellitus, dyslipidemia, and systemic arterial hypertension. In this light, this work aims to build a descriptive review of the relationship between the factors inherent to MS and COVID-19, in order to better clarify the mechanisms belonging to this association. Resistance to the action of insulin caused by centripetal obesity is permeated by an environment abundant in pro-inflammatory cytokines, which favors the immune imbalance, leading to the modulation of dysfunctional and inefficient responses. Besides, it is important to mention the overlapping of inflammatory secretory patterns of MS with the cytokine storm of COVID-19, leading to a worse prognosis. SARS-CoV-2 and arterial hypertension share pathways through a common enzyme: ACE2, widely expressed in the respiratory epithelium and belonging to the pressure regulation cascade. However, dyslipidemia promotes higher morbidity and mortality through increased cardiovascular risk due to thrombotic events. In short, MS represents a critical element to be considered through association with COVID-19, since it interferes in greater severity and mortality through several factors.


    加载中


    Conflict of interest



    The authors declare no conflict of interest.

    Author contribution



    Conception of the manuscript: JNM, GSSC, CRPD and SMB; Data search: VML and RJT; Draft of the manuscript: JNM, GSSC, GAS, VML; Corrections and final Review: JNM, GSSC, CRPD, RJT, CRPD, and SMB; Approval: All the authors approved the final version of the manuscript.

    [1] Harapan H, Itoh N, Yufika A, et al. (2020) Coronavirus disease 2019 (COVID-19): A literature review. J Infect Public Health 13: 667-673. doi: 10.1016/j.jiph.2020.03.019
    [2] Jiang F, Deng L, Zhang L, et al. (2020) Review of the clinical characteristics of coronavirus disease 2019 (COVID-19). J Gen Intern Med 35: 1545-1549. doi: 10.1007/s11606-020-05762-w
    [3] Shi Y, Wang G, Cai XP, et al. (2020) An overview of COVID-19. J Zhejiang Univ Sci B 21: 343-360. doi: 10.1631/jzus.B2000083
    [4] Wang L, Wang Y, Ye D, et al. (2020) Review of the 2019 novel coronavirus (SARS-CoV-2) based on current evidence. Int J Antimicrob Agents 55: 105948.
    [5] Ahn DG, Shin HJ, Kim MH, et al. (2020) Current status of epidemiology, diagnosis, therapeutics, and vaccines for novel coronavirus disease 2019 (COVID-19). J Microbiol Biotechnol 30: 313-324. doi: 10.4014/jmb.2003.03011
    [6] Sohrabi C, Alsafi Z, O'Neill N, et al. (2020) World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 76: 71-76. doi: 10.1016/j.ijsu.2020.02.034
    [7]  World Health Organization, Coronavirus Disease 2019 (COVID-19), Situation Report–83, 2000. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200412-sitrep-83-covid-19.pdf?sfvrsn=697ce98d_4.
    [8] Da Silva C S, Monteiro CRA, Da Silva GHF, et al. (2020) Assessing the metabolic impact of ground chia seed in overweight and obese prepubescent children: results of a double-blind randomized clinical trial. J Med Food 23: 224-232. doi: 10.1089/jmf.2019.0055
    [9] Zhai P, Ding Y, Wu X, et al. (2020) The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents 55: 105955. doi: 10.1016/j.ijantimicag.2020.105955
    [10] Tian S, Hu N, Lou J, et al. (2020) Characteristics of COVID-19 infection in Beijing. J Infect 80: 401-406. doi: 10.1016/j.jinf.2020.02.018
    [11] Ge HP, Wang XF, Yuan XN, et al. (2020) The epidemiology and clinical information about COVID-19. Eur J Clin Microbiol Infect Dis 39: 1011-1019. doi: 10.1007/s10096-020-03874-z
    [12] Madabhavi I, Sarkar M, Kadakol N (2020)  COVID-19: a review. doi: 10.4081/monaldi.2020.1298
    [13] Tufan A, Avanoğlu Güler A, Matucci-Cerinic M (2020) COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci 50: 620-632. doi: 10.3906/sag-2004-168
    [14] Velavan TP, Meyer CG (2020) The COVID-19 epidemic. Trop Med Int Health 25: 278-280. doi: 10.1111/tmi.13383
    [15] Muniyappa R, Gubbi S (2020) COVID-19 pandemic, coronaviruses, and diabetes mellitus. Am J Physiol Endocrinol Metab 318: E736-E741. doi: 10.1152/ajpendo.00124.2020
    [16] Schiffrin EL, Flack JM, Ito S, et al. (2020) Hypertension and COVID-19. Am J Hypertens 33: 373-374. doi: 10.1093/ajh/hpaa057
    [17] Afshin A, Forouzanfar MH, Reitsma MB, et al. (2017) Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med 377: 13-27. doi: 10.1056/NEJMoa1614362
    [18] Ogurtsova K, Da Rocha Fernandes JD, Huang Y, et al. (2017) IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract 128: 40-50. doi: 10.1016/j.diabres.2017.03.024
    [19] Saklayen MG (2018) The global epidemic of the metabolic syndrome. Curr Hypertens Rep 20: 12. doi: 10.1007/s11906-018-0812-z
    [20] Jiang X, Coffee M, Bari A, et al. (2020) Towards an artificial intelligence framework for data-driven prediction of coronavirus clinical severity. Comput Mater Con 63: 537-551.
    [21] McCracken E, Monaghan M, Sreenivasan S (2018) Pathophysiology of the metabolic syndrome. Clin Dermatol 36: 14-20. doi: 10.1016/j.clindermatol.2017.09.004
    [22] Barbalho SM, Tofano RJ, De Campos AL, et al. (2018) Association between vitamin D status and metabolic syndrome risk factors. Diabetes Metab Syndr 12: 501-507. doi: 10.1016/j.dsx.2018.03.011
    [23] Marhl M, Grubelnik V, Magdič M, et al. (2020) Diabetes and metabolic syndrome as risk factors for COVID-19. Diabetes Metab Syndr 14: 671-677. doi: 10.1016/j.dsx.2020.05.013
    [24] Singhal T (2020) A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr 87: 281-286. doi: 10.1007/s12098-020-03263-6
    [25] Soy M, Keser G, Atagündüz P, et al. (2020) Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents used in treatment. Clin Rheumatol 39: 2085-2094. doi: 10.1007/s10067-020-05190-5
    [26] Ye Q, Wang B, Mao J (2020) The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Infect 80: 607-613. doi: 10.1016/j.jinf.2020.03.037
    [27] Butler MJ, Barrientos RM (2020) The impact of nutrition on COVID-19 susceptibility and long-term consequences. Brain Behav Immun 87: 53-54. doi: 10.1016/j.bbi.2020.04.040
    [28] Petrakis D, Margină D, Tsarouhas K, et al. (2020) Obesity—a risk factor for increased COVID-19 prevalence, severity and lethality. Mol Med Rep 22: 9-19. doi: 10.3892/mmr.2020.11127
    [29] Tadic M, Cuspidi C, Sala C (2020)  COVID-19 and diabetes: Is there enough evidence?. doi: 10.1111/jch.13912
    [30] Engin AB, Engin ED, Engin A (2020) Two important controversial risk factors in SARS-CoV-2 infection: obesity and smoking. Environ Toxicol Pharmacol 78: 103411. doi: 10.1016/j.etap.2020.103411
    [31] Ryan PM, Caplice NM (2020)  Is adipose tissue a reservoir for viral spread, immune activation, and cytokine amplification in coronavirus disease 2019?. doi: 10.1002/oby.22843
    [32] Zabetakis I, Lordan R, Norton C, et al. (2020) COVID-19: The inflammation link and the role of nutrition in potential mitigation. Nutrients 12: 1466. doi: 10.3390/nu12051466
    [33] Dhar D, Mohanty A (2020) Gut microbiota and Covid-19- possible link and implications. Virus Res 285: 198018. doi: 10.1016/j.virusres.2020.198018
    [34] Araújo JR, Tomas J, Brenner C, et al. (2017) Impact of high-fat diet on the intestinal microbiota and small intestinal physiology before and after the onset of obesity. Biochimie 141: 97-106. doi: 10.1016/j.biochi.2017.05.019
    [35] Cox AJ, West NP, Cripps AW (2015) Obesity, inflammation, and the gut microbiota. Lancet Diabetes Endocrinol 3: 207-215. doi: 10.1016/S2213-8587(14)70134-2
    [36] Gupta R, Hussain A, Misra A (2020) Diabetes and COVID-19: evidence, current status and unanswered research questions. Eur J Clin Nutr 74: 864-870. doi: 10.1038/s41430-020-0652-1
    [37] Hussain A, Bhowmik B, Do Vale Moreira NC (2020) COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract 162: 108142. doi: 10.1016/j.diabres.2020.108142
    [38] Schofield J, Leelarathna L, Thabit H (2020) COVID-19: Impact of and on diabetes. Diabetes Ther 11: 1429-1435. doi: 10.1007/s13300-020-00847-5
    [39] Cristelo C, Azevedo C, Marques JM, et al. (2020) SARS-CoV-2 and diabetes: New challenges for the disease. Diabetes Res Clin Pract 164: 108228. doi: 10.1016/j.diabres.2020.108228
    [40] Gupta R, Ghosh A, Singh AK, et al. (2020) Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes Metab Syndr 14: 211-212. doi: 10.1016/j.dsx.2020.03.002
    [41] Brufsky A (2020) Hyperglycemia, hydroxychloroquine, and the COVID-19 pandemic. J Med Virol 92: 770-775. doi: 10.1002/jmv.25887
    [42] Drucker DJ (2020) Coronavirus infections and type 2 diabetes—shared pathways with therapeutic implications. Endocr Rev 41: 457-470. doi: 10.1210/endrev/bnaa011
    [43] Orioli L, Hermans MP, Thissen JP, et al. (2020) COVID-19 in diabetic patients: Related risks and specifics of management. Ann Endocrinol 81: 101-109. doi: 10.1016/j.ando.2020.05.001
    [44] Sardu C, Gambardella J, Morelli MB, et al. (2020) Hypertension, thrombosis, kidney failure, and diabetes: Is COVID-19 an endothelial disease? A comprehensive evaluation of clinical and basic evidence. J Clin Med 9: 1417. doi: 10.3390/jcm9051417
    [45] Zheng Z, Peng F, Xu B, et al. (2020)  Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. doi: 10.1016/j.jinf.2020.04.021
    [46] Bouhanick B, Cracowski JL, Faillie JL (2020)  Diabetes and COVID-19. doi: 10.1016/j.therap.2020.05.006
    [47] Zheng YY, Ma YT, Zhang JY, et al. (2020) COVID-19 and the cardiovascular system. Nat Rev Cardiol 17: 259-260. doi: 10.1038/s41569-020-0360-5
    [48] Li B, Yang J, Zhao F, et al. (2020) Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol 109: 531-538. doi: 10.1007/s00392-020-01626-9
    [49] Ke C, Zhu X, Zhang Y, et al. (2018) Metabolomic characterization of hypertension and dyslipidemia. Metabolomics 14: 117. doi: 10.1007/s11306-018-1408-y
    [50] Chobanian AV (2017) Guidelines for the management of hypertension. Med Clin N Am 101: 219-227. doi: 10.1016/j.mcna.2016.08.016
    [51] Gupta R, Misra A (2020) Contentious issues and evolving concepts in the clinical presentation and management of patients with COVID-19 infectionwith reference to use of therapeutic and other drugs used in Co-morbid diseases (Hypertension, diabetes etc). Diabetes Metab Syndr 14: 251-254. doi: 10.1016/j.dsx.2020.03.012
    [52] Cheng H, Wang Y, Wang GQ (2020) Organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19. J Med Virol 92: 726-730. doi: 10.1002/jmv.25785
    [53] South AM, Diz DI, Chappell MC (2020) COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circ Physiol 318: H1084-H1090. doi: 10.1152/ajpheart.00217.2020
    [54] D'Ardes D, Boccatonda A, Rossi I, et al. (2020) COVID-19 and RAS: unravelling an unclear relationship. Int J Mol Sci 21: 3003. doi: 10.3390/ijms21083003
    [55] Angel-Korman A, Brosh T, Glick K, et al. (2020) COVID-19, the kidney and hypertension. Harefuah 159: 231-234.
    [56] Wang D, Hu B, Hu C, et al. (2020) Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama 323: 1061-1069. doi: 10.1001/jama.2020.1585
    [57] Meng J, Xiao G, Zhang J, et al. (2020) Renin-angiotensin system inhibitors improve the clinical outcomes of COVID-19 patients with hypertension. Emerg Microbes Infect 9: 757-760. doi: 10.1080/22221751.2020.1746200
    [58] Cao X, Yin R, Albrecht H, et al. (2020) Cholesterol: A new game player accelerating endothelial injuries caused by SARS-CoV-2? Am J Physiol Endocrinol Metab 319: E197-E202. doi: 10.1152/ajpendo.00255.2020
    [59] Silva AME, Aguiar C, Duarte J S, et al. (2019) CODAP: A multidisciplinary consensus among Portuguese experts on the definition, detection and management of atherogenic dyslipidemia. Rev Port Cardiol 38: 531-542. doi: 10.1016/j.repc.2019.03.005
    [60] Helkin A, Stein JJ, Lin S, et al. (2016) Dyslipidemia part 1—review of lipid metabolism and vascular cell physiology. Vasc Endovascular Surg 50: 107-118. doi: 10.1177/1538574416628654
    [61] Zheng KI, Gao F, Wang XB, et al. (2020) Letter to the Editor: Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease. Metabolism 108: 154244. doi: 10.1016/j.metabol.2020.154244
    [62] Vekic J, Zeljkovic A, Stefanovic A, et al. (2019) Obesity and dyslipidemia. Metabolism 92: 71-81. doi: 10.1016/j.metabol.2018.11.005
    [63] Wei X, Zeng W, Su J, et al. (2020) Hypolipidemia is associated with the severity of COVID-19. J Clin Lipidol 14: 297-304. doi: 10.1016/j.jacl.2020.04.008
    [64] Vuorio A, Watts GF, Kovanen PT (2020) Familial hypercholesterolaemia and COVID-19: triggering of increased sustained cardiovascular risk. J Intern Med 287: 746-747. doi: 10.1111/joim.13070
  • Reader Comments
  • © 2020 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(5507) PDF downloads(420) Cited by(8)

Article outline

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog