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Wang H, Xiao D, Zhou H, Chen S, Xiao G, Hu J, Quan H, Luo M, Zhang S. Visceral Adiposity and Neutralizing Antibody Expression: An Adult-Based Cross-Sectional Study. J Inflamm Res 2024; 17:5633-5643. [PMID: 39219813 PMCID: PMC11363935 DOI: 10.2147/jir.s477526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose Visceral adiposity is a significant risk factor for severe COVID-19. However, the impact of the Chinese visceral adiposity index (CVAI) on the efficacy of SARS-CoV-2 vaccines remains poorly understood. This study aims to explore the impact of CVAI on the production of neutralizing antibodies (NAb) in inactivated SARS-CoV-2 vaccines and the potential mechanism, thereby optimizing vaccination guidance. Methods In this cross-sectional study, 206 health workers (completed two SARS-CoV-2 vaccination on February 8th and March 10th, 2021, respectively) were recruited. All baseline anthropometric parameters of the participants were collected, and venous blood samples were obtained 6 weeks later to measure peripheral innate immune cells, inflammatory cytokines, and NAb titers against SARS-CoV-2. CVAI were calculated according to the formula and divided participants into two groups depending on CVAI median. Results The median NAb titer among healthcare workers was 12.94 AU/mL, with an efficacy of 87.86% for the SARS-CoV-2 vaccine. NAb titers were lower in the CVAI dysfunction group than in the CVAI reference group (median: 11.40 AU/mL vs 15.57 AU/mL), the hsCRP levels (median: 0.50 mg/L vs 0.30 mg/L) and peripheral monocyte count (mean: 0.47 × 109/L vs 0.42 × 109/L) in the CVAI dysfunction group were higher than in the CVAI reference group. Additionally, CVAI showed positive correlations with hsCRP, monocytes, lymphocytes, and B-lymphocytes, and a negative correlation with NAb titers. Conclusion CVAI may inhibit SARS-CoV-2 neutralizing antibody expression through inducing immune dysfunction and chronic inflammation. Thus, more attention should be paid to the vaccination for high CVAI population to improve the effectiveness of vaccination, which could provide more robust support for COVID-19 epidemic prevention and control.
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Affiliation(s)
- Huanhuan Wang
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
| | - Dan Xiao
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chengdu Medical College (Nuclear Industry 416 Hospital), Chengdu, Sichuan, People’s Republic of China
| | - Hua Zhou
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Shu Chen
- Department of Laboratory Medicine, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
| | - Guangjun Xiao
- Department of Laboratory Medicine, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
| | - Juan Hu
- Department of Laboratory Medicine, Suining Central Hospital, Suining, Sichuan, People’s Republic of China
| | - Hui Quan
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chengdu Medical College (Nuclear Industry 416 Hospital), Chengdu, Sichuan, People’s Republic of China
| | - Miao Luo
- Department of Laboratory Medicine, the People’s Hospital of Yubei District of Chongqing, Chongqing, People’s Republic of China
| | - Shaocheng Zhang
- Department of Laboratory Medicine, the Second Affiliated Hospital of Chengdu Medical College (Nuclear Industry 416 Hospital), Chengdu, Sichuan, People’s Republic of China
- School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, People’s Republic of China
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Quarleri J, Delpino MV. The interplay of aging, adipose tissue, and COVID-19: a potent alliance with implications for health. GeroScience 2024; 46:2915-2932. [PMID: 38191833 PMCID: PMC11009220 DOI: 10.1007/s11357-023-01058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/27/2023] [Indexed: 01/10/2024] Open
Abstract
Obesity has emerged as a significant public health challenge. With the ongoing increase in life expectancy, the prevalence of obesity is steadily growing, particularly among older age demographics. The extension of life expectancy frequently results in additional years of vulnerability to chronic health issues associated with obesity in the elderly.The concept of SARS-CoV-2 directly infecting adipose tissue stems from the fact that both adipocytes and stromal vascular fraction cells express ACE2, the primary receptor facilitating SARS-CoV-2 entry. It is noteworthy that adipose tissue demonstrates ACE2 expression levels similar to those found in the lungs within the same individual. Additionally, ACE2 expression in the adipose tissue of obese individuals surpasses that in non-obese counterparts. Viral attachment to ACE2 has the potential to disturb the equilibrium of renin-angiotensin system homeostasis, leading to an exacerbated inflammatory response.Consequently, adipose tissue has been investigated as a potential site for active SARS-CoV-2 infection, suggesting its plausible role in virus persistence and contribution to both acute and long-term consequences associated with COVID-19.This review is dedicated to presenting current evidence concerning the presence of SARS-CoV-2 in the adipose tissue of elderly individuals infected with the virus. Both obesity and aging are circumstances that contribute to severe health challenges, heightening the risk of disease and mortality. We will particularly focus on examining the mechanisms implicated in the long-term consequences, with the intention of providing insights into potential strategies for mitigating the aftermath of the disease.
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Affiliation(s)
- Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Universidad de Buenos Aires, CONICET, Paraguay 2155, Piso 11, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina.
| | - M Victoria Delpino
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Universidad de Buenos Aires, CONICET, Paraguay 2155, Piso 11, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina.
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Gavronova A, Hamerlik L, Bartkova M, Svrchokryl V, Kralikova V, Vranova K, Ondra P, Dobias M. Fat embolism and COVID-19 infection: autopsy and post-mortem laboratory findings in SARS-CoV-2 positive patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024. [PMID: 38818791 DOI: 10.5507/bp.2024.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION The article is one of the very first autopsy reports worldwide, which associates COVID-19 infection and pulmonary fat embolism. AIMS To point to a crucial connection between a severe acute respiratory syndrome caused by coronavirus 2 (SARS-CoV-2) infection and pulmonary fat embolism as one of the possible major mechanisms of severe COVID-19 symptoms. METHODS Lung, brain and kidney tissues examination of 16 full human autopsy cases. All deceased suffered from COVID-19 infection, none of them was admitted to hospital prior to death, immediate causes of death vary. Autopsies accompanied by microbiological examination and histological examination using Oil Red O staining were performed. Consequently, we have implemented a control cohort consisting of 16 deceased with no presence of pulmonary infection and various immediate causes of death. RESULTS Of the 16 autopsy cases, 11 (68.8%) were males and 5 (31.3%) females, with overall mean age 68.1 (39-86) years. Causes of death of studied subjects were natural, mostly from respiratory failure (in 12 cases, 75%). Cardiopulmonary resuscitation was performed in 7 cases (43.8%). None of dissected persons had larger signs of body trauma. Pulmonary fat embolism was found in 11 cases (68.8%), which generalised to kidneys in 8 patients (50% of all cases, 72.3% of cases with pulmonary fat embolism) and to brain tissue in 1 case. CONCLUSION We demonstrated a reasonable relation between a COVID-19 disease and a variously severe fat embolism, severity of which does not directly correlate with body weight. Further investigation or even change of medical treatment needs to be considered in patients with COVID-19.
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Affiliation(s)
- Adriana Gavronova
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Lukas Hamerlik
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Margita Bartkova
- Clinical laboratory, Psychiatric Hospital Sternberk, Czech Republic
| | - Vaclav Svrchokryl
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Veronika Kralikova
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Katerina Vranova
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Peter Ondra
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Martin Dobias
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Czech Republic
- Department of Forensic Medicine and Medical Law, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Qiu B, Zandkarimi F, Saqi A, Castagna C, Tan H, Sekulic M, Miorin L, Hibshoosh H, Toyokuni S, Uchida K, Stockwell BR. Fatal COVID-19 pulmonary disease involves ferroptosis. Nat Commun 2024; 15:3816. [PMID: 38769293 PMCID: PMC11106344 DOI: 10.1038/s41467-024-48055-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
SARS-CoV-2 infection causes severe pulmonary manifestations, with poorly understood mechanisms and limited treatment options. Hyperferritinemia and disrupted lung iron homeostasis in COVID-19 patients imply that ferroptosis, an iron-dependent cell death, may occur. Immunostaining and lipidomic analysis in COVID-19 lung autopsies reveal increases in ferroptosis markers, including transferrin receptor 1 and malondialdehyde accumulation in fatal cases. COVID-19 lungs display dysregulation of lipids involved in metabolism and ferroptosis. We find increased ferritin light chain associated with severe COVID-19 lung pathology. Iron overload promotes ferroptosis in both primary cells and cancerous lung epithelial cells. In addition, ferroptosis markers strongly correlate with lung injury severity in a COVID-19 lung disease model using male Syrian hamsters. These results reveal a role for ferroptosis in COVID-19 pulmonary disease; pharmacological ferroptosis inhibition may serve as an adjuvant therapy to prevent lung damage during SARS-CoV-2 infection.
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Affiliation(s)
- Baiyu Qiu
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Fereshteh Zandkarimi
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
- Mass Spectrometry Core Facility, Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Anjali Saqi
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Candace Castagna
- Institute of Comparative Medicine, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Hui Tan
- Department of Chemistry, Columbia University, New York, NY, 10027, USA
| | - Miroslav Sekulic
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Lisa Miorin
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Hanina Hibshoosh
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Shinya Toyokuni
- Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
- Center for Low-temperature Plasma Sciences, Nagoya University, Furo-Cho, Chikusa-ku, Nagoya, 464-8603, Japan
| | - Koji Uchida
- Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, 113-8657, Japan
| | - Brent R Stockwell
- Department of Chemistry, Columbia University, New York, NY, 10027, USA.
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, NY, 10032, USA.
- Department of Biological Sciences, Columbia University, New York, NY, 10027, USA.
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Araújo VA, Souza JS, Giglio BM, Lobo PCB, Pimentel GD. Association of Calf Circumference with Clinical and Biochemical Markers in Older Adults with COVID-19 Admitted at Intensive Care Unit: A Retrospective Cross-Sectional Study. Diseases 2024; 12:97. [PMID: 38785752 PMCID: PMC11119336 DOI: 10.3390/diseases12050097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND COVID-19 is an infectious disease characterized by a severe catabolic and inflammatory state, leading to loss of muscle mass. The assessment of muscle mass can be useful to identify nutritional risk and assist in early management, especially in older adults who have high nutritional risks. The aim of this study was to evaluate the association of calf circumference (CC) with clinical and biochemical markers and mortality in older adults with COVID-19 admitted to the intensive care unit (ICU). METHODS A retrospective cross-sectional study was conducted in a public hospital. CC was adjusted for body mass index (BMI), reducing 3, 7, or 12 cm for a BMI of 25-29.9, 30-39.9, and ≥40 kg/m2, respectively, and classified as reduced when <33 cm for women and <34 cm for men. Pearson's correlation between BMI and CC was performed to assess the association between variables. Regression analysis was adjusted for sex, age, and BMI variables. Cox regression was used to assess survival related to CC. RESULTS A total of 208 older adults diagnosed with COVID-19 admitted to ICU were included, of which 84% (n = 176) were classified as having reduced CC. These patients were older, with lower BMI, higher nutritional risk, malnourished, and higher concentration of urea and urea-creatinine ratio (UCR) compared with the group with normal CC. There was an association between edematous patients at nutritional risk and malnourished with reduced CC in the Cox regression, either adjusted or not for confounding. CONCLUSIONS CC was not associated with severity, biochemical markers, or mortality in older adults with COVID-19 admitted to the ICU, but it was associated with moderately malnourished patients assessed by subjective global assessment (SGA).
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Affiliation(s)
| | | | | | | | - Gustavo D. Pimentel
- Faculty of Nutrition, Federal University of Goiás, Goiânia 74605080, Brazil; (V.A.A.); (J.S.S.); (B.M.G.); (P.C.B.L.)
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Quaranta P, Scabia G, Storti B, Dattilo A, Quintino L, Perrera P, Di Primio C, Costa M, Pistello M, Bizzarri R, Maffei M. SARS-CoV-2 Infection Alters the Phenotype and Gene Expression of Adipocytes. Int J Mol Sci 2024; 25:2086. [PMID: 38396763 PMCID: PMC10889321 DOI: 10.3390/ijms25042086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Epidemiological evidence emphasizes that excess fat mass is associated with an increased risk of severe COVID-19 disease. Nevertheless, the intricate interplay between SARS-CoV-2 and adipocytes remains poorly understood. It is crucial to decipher the progression of COVID-19 both in the acute phase and on long-term outcomes. In this study, an in vitro model using the human SGBS cell line (Simpson-Golabi-Behmel syndrome) was developed to investigate the infectivity of SARS-CoV-2 in adipocytes, and the effects of virus exposure on adipocyte function. Our results show that SGBS adipocytes expressing ACE2 are susceptible to SARS-CoV-2 infection, as evidenced by the release of the viral genome into the medium, detection of the nucleocapsid in cell lysates, and positive immunostaining for the spike protein. Infected adipocytes show remarkable changes compared to uninfected controls: increased surface area of lipid droplets, upregulated expression of genes of inflammation (Haptoglobin, MCP-1, IL-6, PAI-1), increased oxidative stress (MnSOD), and a concomitant reduction of transcripts related to adipocyte function (leptin, fatty acid synthase, perilipin). Moreover, exogenous expression of spike protein in SGBS adipocytes also led to an increase in lipid droplet size. In conclusion using the human SGBS cell line, we detected SARS-CoV-2 infectivity in adipocytes, revealing substantial morphological and functional changes in infected cells.
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Affiliation(s)
- Paola Quaranta
- Retrovirus Center, Virology Section, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 10, 56126 Pisa, Italy; (P.Q.); (P.P.); (M.P.)
- National Research Council—Institute of Neuroscience, Via Moruzzi 1, 56124 Pisa, Italy; (C.D.P.); (M.C.)
| | - Gaia Scabia
- National Research Council—Institute of Clinical Physiology, Via Moruzzi 1, 56124 Pisa, Italy; (G.S.); (L.Q.)
- Center for Obesity and Lipodystrophy, Pisa University-Hospital, Via Paradisa 2, 56124 Pisa, Italy;
| | - Barbara Storti
- National Enterprise for nanoScience and nanoTechnology, Scuola Normale Superiore, National Research Council—Institute of Nanoscience, Piazza San Silvestro 12, 56127 Pisa, Italy;
| | - Alessia Dattilo
- Center for Obesity and Lipodystrophy, Pisa University-Hospital, Via Paradisa 2, 56124 Pisa, Italy;
| | - Lara Quintino
- National Research Council—Institute of Clinical Physiology, Via Moruzzi 1, 56124 Pisa, Italy; (G.S.); (L.Q.)
| | - Paola Perrera
- Retrovirus Center, Virology Section, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 10, 56126 Pisa, Italy; (P.Q.); (P.P.); (M.P.)
| | - Cristina Di Primio
- National Research Council—Institute of Neuroscience, Via Moruzzi 1, 56124 Pisa, Italy; (C.D.P.); (M.C.)
| | - Mario Costa
- National Research Council—Institute of Neuroscience, Via Moruzzi 1, 56124 Pisa, Italy; (C.D.P.); (M.C.)
| | - Mauro Pistello
- Retrovirus Center, Virology Section, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Savi 10, 56126 Pisa, Italy; (P.Q.); (P.P.); (M.P.)
- Virology Unit, Pisa University-Hospital, Via Paradisa 2, 56124 Pisa, Italy
| | - Ranieri Bizzarri
- National Enterprise for nanoScience and nanoTechnology, Scuola Normale Superiore, National Research Council—Institute of Nanoscience, Piazza San Silvestro 12, 56127 Pisa, Italy;
- Department of Surgical, Medical and Molecular Pathology, and Critical Care Medicine, University of Pisa, Via Roma 65, 56126 Pisa, Italy
| | - Margherita Maffei
- National Research Council—Institute of Clinical Physiology, Via Moruzzi 1, 56124 Pisa, Italy; (G.S.); (L.Q.)
- Center for Obesity and Lipodystrophy, Pisa University-Hospital, Via Paradisa 2, 56124 Pisa, Italy;
- Italian National Institute for Nuclear Physics, Via Filippo Buonarroti 3, 56127 Pisa, Italy
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Moser J, Emous M, Heeringa P, Rodenhuis-Zybert IA. Mechanisms and pathophysiology of SARS-CoV-2 infection of the adipose tissue. Trends Endocrinol Metab 2023; 34:735-748. [PMID: 37673763 DOI: 10.1016/j.tem.2023.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/08/2023]
Abstract
Obesity is an independent risk factor for severe COVID-19, yet there remains a lack of consensus on the mechanisms underlying this relationship. A hypothesis that has garnered considerable attention suggests that SARS-CoV-2 disrupts adipose tissue function, either through direct infection or by indirect mechanisms. Indeed, recent reports have begun to shed some light on the important role that the adipose tissue plays during the acute phase of infection, as well as mediating long-term sequelae. In this review, we examine the evidence of extrapulmonary dissemination of SARS-CoV-2 to the adipose tissue. We discuss the mechanisms, acute and long-term implications, and possible management strategies to limit or ameliorate severe disease and long-term metabolic disturbances.
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Affiliation(s)
- Jill Moser
- Department of Critical Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Marloes Emous
- Center Obesity Northern Netherlands (CON), Department of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Peter Heeringa
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Izabela A Rodenhuis-Zybert
- Department of Medical Microbiology & Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Kong J, Yang T, Zhang F, Liao X, Du S, Yang X, Li D. Pulmonary fat embolism: a potentially new fatal complication of SARS-CoV-2 infection. A case report. BMC Infect Dis 2023; 23:576. [PMID: 37667198 PMCID: PMC10478277 DOI: 10.1186/s12879-023-08559-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND So far, there have been more than 761 million confirmed cases of SARS-CoV-2 worldwide, with more than 6.8 million deaths. The most common direct causes of death for COVID-19 are diffuse alveolar injury and acute respiratory distress syndrome. Autopsy results have shown that 80-100% of COVID-19 patients have microthrombi which is 9 times higher than in patients with influenza. There are reported cases of fat embolism associated with Covid-19, but relevant epidemiological investigations and fatal cases of pulmonary fat embolism are lacking. In this report, we describe the first COVID-19 patient to die from pulmonary fat embolism. CASE PRESENTATION A 54-year-old woman suddenly felt unwell while at work. She had difficulty breathing for 40 min and lost consciousness for 20 min before being taken to the hospital. On admission, her temperature was 36 ℃, but her respiration, heart rate, and blood pressure were undetectable. Laboratory examination revealed C-reactive protein, 26.55 mg/L; D-dimer, 11,400 µg/L; and procalcitonin, 0.21 ng/mL. She was declared clinically dead 2 h after admission due to ineffective rescue efforts. At autopsy, both lungs were highly oedematous with partial alveolar haemorrhage. The presence of microthrombi and pulmonary fat embolism in small interstitial pulmonary vessels was confirmed by phosphotungstic acid haematoxylin staining and oil red O staining. The immunohistochemical results of spike protein and nucleocapsid protein in laryngeal epithelial cells confirmed SARS-CoV-2 infection. CONCLUSIONS Pulmonary fat embolism may be another fatal complication of COVID-19 infection, and clinicians should pay more attention to it.
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Affiliation(s)
- Jiangwei Kong
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Tengfei Yang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Fu Zhang
- Forensic Pathology Lab, Guangdong Public Security Department, Forensic Department of Criminal Investigation Bureau, Guangzhou, Guangdong, 510050, People's Republic of China
| | - XinBiao Liao
- Forensic Pathology Lab, Guangdong Public Security Department, Forensic Department of Criminal Investigation Bureau, Guangzhou, Guangdong, 510050, People's Republic of China
| | - Sihao Du
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Xingan Yang
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China
| | - Dongri Li
- Department of Forensic Pathology, School of Forensic Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, People's Republic of China.
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Steenblock C, Toepfner N, Beuschlein F, Perakakis N, Mohan Anjana R, Mohan V, Mahapatra NR, Bornstein SR. SARS-CoV-2 infection and its effects on the endocrine system. Best Pract Res Clin Endocrinol Metab 2023; 37:101761. [PMID: 36907787 PMCID: PMC9985546 DOI: 10.1016/j.beem.2023.101761] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing corona virus disease 2019 (COVID-19) can infect multiple tissues, including endocrine organs, such as the pancreas, adrenal, thyroid, and adipose tissue. The main receptor for SARS-CoV-2, ACE2, is ubiquitously expressed in the cells of the endocrine organs and accordingly, the virus has been detected in various amounts in all endocrine tissues in post-mortem samples from COVID-19 patients. The infection with SARS-CoV-2 may directly lead to organ damage or dysfunction, such as hyperglycaemia or in rare cases, new-onset diabetes. Furthermore, an infection with SARS-CoV-2 may have indirect effects affecting the endocrine system. The exact mechanisms are not yet completely understood and have to be further investigated. Conversely, endocrine diseases may affect the severity of COVID-19 and emphasis has to be laid on reducing the prevalence, or enhance the treatment, of these often non-communicable diseases in the future.
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Affiliation(s)
- Charlotte Steenblock
- Department of Internal Medicine III, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Nicole Toepfner
- Department of Pediatrics, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zürich, Switzerland
| | - Nikolaos Perakakis
- Department of Internal Medicine III, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, University Hospital and Faculty of Medicine, TU Dresden, Dresden, Germany; German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Ranjit Mohan Anjana
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Nitish R Mahapatra
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai, India
| | - Stefan R Bornstein
- Department of Internal Medicine III, University Clinic Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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10
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Waddell T, Namburete AIL, Duckworth P, Eichert N, Thomaides-Brears H, Cuthbertson DJ, Despres JP, Brady M. Bayesian networks and imaging-derived phenotypes highlight the role of fat deposition in COVID-19 hospitalisation risk. FRONTIERS IN BIOINFORMATICS 2023; 3:1163430. [PMID: 37293292 PMCID: PMC10244647 DOI: 10.3389/fbinf.2023.1163430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Objective: Obesity is a significant risk factor for adverse outcomes following coronavirus infection (COVID-19). However, BMI fails to capture differences in the body fat distribution, the critical driver of metabolic health. Conventional statistical methodologies lack functionality to investigate the causality between fat distribution and disease outcomes. Methods: We applied Bayesian network (BN) modelling to explore the mechanistic link between body fat deposition and hospitalisation risk in 459 participants with COVID-19 (395 non-hospitalised and 64 hospitalised). MRI-derived measures of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and liver fat were included. Conditional probability queries were performed to estimate the probability of hospitalisation after fixing the value of specific network variables. Results: The probability of hospitalisation was 18% higher in people living with obesity than those with normal weight, with elevated VAT being the primary determinant of obesity-related risk. Across all BMI categories, elevated VAT and liver fat (>10%) were associated with a 39% mean increase in the probability of hospitalisation. Among those with normal weight, reducing liver fat content from >10% to <5% reduced hospitalisation risk by 29%. Conclusion: Body fat distribution is a critical determinant of COVID-19 hospitalisation risk. BN modelling and probabilistic inferences assist our understanding of the mechanistic associations between imaging-derived phenotypes and COVID-19 hospitalisation risk.
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Affiliation(s)
- T. Waddell
- Department of Engineering Science, The University of Oxford, Oxford, United Kingdom
- Perspectum Ltd., Oxford, United Kingdom
| | - A. I. L. Namburete
- Department of Computer Science, University of Oxford, Oxford, United Kingdom
| | - P. Duckworth
- Oxford Robotics Institute, The University of Oxford, Oxford, United Kingdom
| | | | | | - D. J. Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - J. P. Despres
- Scientific director of VITAM – Research Center for Sustainable Health, Laval University, Quebec, QC, Canada
| | - M. Brady
- Perspectum Ltd., Oxford, United Kingdom
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11
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Barthelemy J, Bogard G, Wolowczuk I. Beyond energy balance regulation: The underestimated role of adipose tissues in host defense against pathogens. Front Immunol 2023; 14:1083191. [PMID: 36936928 PMCID: PMC10019896 DOI: 10.3389/fimmu.2023.1083191] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/09/2023] [Indexed: 03/06/2023] Open
Abstract
Although the adipose tissue (AT) is a central metabolic organ in the regulation of whole-body energy homeostasis, it is also an important endocrine and immunological organ. As an endocrine organ, AT secretes a variety of bioactive peptides known as adipokines - some of which have inflammatory and immunoregulatory properties. As an immunological organ, AT contains a broad spectrum of innate and adaptive immune cells that have mostly been studied in the context of obesity. However, overwhelming evidence supports the notion that AT is a genuine immunological effector site, which contains all cell subsets required to induce and generate specific and effective immune responses against pathogens. Indeed, AT was reported to be an immune reservoir in the host's response to infection, and a site of parasitic, bacterial and viral infections. In addition, besides AT's immune cells, preadipocytes and adipocytes were shown to express innate immune receptors, and adipocytes were reported as antigen-presenting cells to regulate T-cell-mediated adaptive immunity. Here we review the current knowledge on the role of AT and AT's immune system in host defense against pathogens. First, we will summarize the main characteristics of AT: type, distribution, function, and extraordinary plasticity. Second, we will describe the intimate contact AT has with lymph nodes and vessels, and AT immune cell composition. Finally, we will present a comprehensive and up-to-date overview of the current research on the contribution of AT to host defense against pathogens, including the respiratory viruses influenza and SARS-CoV-2.
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Affiliation(s)
| | | | - Isabelle Wolowczuk
- Univ. Lille, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019 - UMR 9017 - Center for Infection and Immunity of Lille (CIIL), Lille, France
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12
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Alsaghir A, Alsaghir L, Alsaif J, Mobeireek A. Successful therapeutic plasma exchange for a patient with sickle cell disease and fat embolism syndrome after a failure of a response to red cell exchange transfusion. Transfusion 2023; 63 Suppl 1:S33-S36. [PMID: 36748667 DOI: 10.1111/trf.17220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 11/11/2022] [Accepted: 11/29/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Fat embolism syndrome (FES) is a rare complication, which was reported mostly with milder forms of heterozygous sickle cell disease (SCD). It may present in a catastrophic way with multi-organ failure, particularly involving the pulmonary and neurological systems. Diagnosis is often missed or delayed; and the standard recommended treatment is red cell exchange (RCE) transfusion, which has sub-optimal results, such as debilitating long-term neurological complications. Recently, few reports suggested that the addition of Therapeutic Plasma Exchange (TPE) might further improve the outcome. CASE DESCRIPTION A 23-year-old woman with homozygote SCD was admitted with bony pains and vaso-occlusive crises. However, her course evolved to respiratory failure requiring mechanical ventilation, decreased level of consciousness, skin rash, severe anemia and thrombocytopenia and a picture consistent with thrombotic microangiopathy. MRI of the brain showed scattered multi-focal ischemic foci and cytotoxic edema. The patient received RCE on the third day after admission without improvement. On the seventh day, TPE was instituted (2 L/day of fresh frozen plasma for 5 days), following which she regained her consciousness and showed an improvement in her laboratory abnormalities. On follow up, she had gradual full neurological recovery and resolution of the MRI findings within a few months. CONCLUSION FES remains a diagnostic and therapeutic challenge, with significant morbidity and mortality. Success in the management of this reported case with the addition of TPE to RCE supports the notion that TPE may be a potentially helpful modality that deserves further research.
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Affiliation(s)
- Abdullah Alsaghir
- Pulmonary & Critical Care Medicine, Dammam Medical Complex, Dammam, Saudi Arabia
| | - Lina Alsaghir
- Royal College of Surgeons in Ireland- Bahrain, Busaiteen, Bahrain
| | - Janat Alsaif
- Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah Mobeireek
- Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
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13
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Bogard G, Barthelemy J, Hantute-Ghesquier A, Sencio V, Brito-Rodrigues P, Séron K, Robil C, Flourens A, Pinet F, Eberlé D, Trottein F, Duterque-Coquillaud M, Wolowczuk I. SARS-CoV-2 infection induces persistent adipose tissue damage in aged golden Syrian hamsters. Cell Death Dis 2023; 14:75. [PMID: 36725844 PMCID: PMC9891765 DOI: 10.1038/s41419-023-05574-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 02/03/2023]
Abstract
Coronavirus disease 2019 (COVID-19, caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2)) is primarily a respiratory illness. However, various extrapulmonary manifestations have been reported in patients with severe forms of COVID-19. Notably, SARS-CoV-2 was shown to directly trigger white adipose tissue (WAT) dysfunction, which in turn drives insulin resistance, dyslipidemia, and other adverse outcomes in patients with COVID-19. Although advanced age is the greatest risk factor for COVID-19 severity, published data on the impact of SARS-CoV-2 infection on WAT in aged individuals are scarce. Here, we characterized the response of subcutaneous and visceral WAT depots to SARS-CoV-2 infection in young adult and aged golden hamsters. In both age groups, infection was associated with a decrease in adipocyte size in the two WAT depots; this effect was partly due to changes in tissue's lipid metabolism and persisted for longer in aged hamsters than in young-adult hamsters. In contrast, only the subcutaneous WAT depot contained crown-like structures (CLSs) in which dead adipocytes were surrounded by SARS-CoV-2-infected macrophages, some of them forming syncytial multinucleated cells. Importantly, older age predisposed to a unique manifestation of viral disease in the subcutaneous WAT depot during SARS-CoV-2 infection; the persistence of very large CLSs was indicative of an age-associated defect in the clearance of dead adipocytes by macrophages. Moreover, we uncovered age-related differences in plasma lipid profiles during SARS-CoV-2 infection. These data suggest that the WAT's abnormal response to SARS-CoV-2 infection may contribute to the greater severity of COVID-19 observed in elderly patients.
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Affiliation(s)
- Gemma Bogard
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Johanna Barthelemy
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Aline Hantute-Ghesquier
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Valentin Sencio
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Patricia Brito-Rodrigues
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Karin Séron
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Cyril Robil
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Anne Flourens
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Florence Pinet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000, Lille, France
| | - Delphine Eberlé
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, F-59000, Lille, France
| | - François Trottein
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France
| | - Martine Duterque-Coquillaud
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000, Lille, France
| | - Isabelle Wolowczuk
- Univ. Lille, Institut National de la Santé et de la Recherche Médicale (Inserm), Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Lille (CHU Lille), Institut Pasteur de Lille, U1019-UMR9017-Center for Infection and Immunity of Lille (CIIL), F-59000, Lille, France.
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14
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Traina G. The Connection between Gut and Lung Microbiota, Mast Cells, Platelets and SARS-CoV-2 in the Elderly Patient. Int J Mol Sci 2022; 23:ijms232314898. [PMID: 36499222 PMCID: PMC9740794 DOI: 10.3390/ijms232314898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
The human coronavirus SARS-CoV-2 or COVID-19 that emerged in late 2019 causes a respiratory tract infection and has currently resulted in more than 627 million confirmed cases and over 6.58 million deaths worldwide up to October 2022. The highest death rate caused by COVID-19 is in older people, especially those with comorbidities. This evidence presents a challenge for biomedical research on aging and also identifies some key players in inflammation, including mast cells and platelets, which could represent important markers and, at the same time, unconventional therapeutic targets. Studies have shown a decrease in the diversity of gut microbiota composition in the elderly, particularly a reduced abundance of butyrate-producing species, and COVID-19 patients manifest faecal microbiome alterations, with an increase in opportunistic pathogens and a depletion of commensal beneficial microorganisms. The main purpose of this narrative review is to highlight how an altered condition of the gut microbiota, especially in the elderly, could be an important factor and have a strong impact in the lung homeostasis and COVID-19 phenomenon, jointly to the activation of mast cells and platelets, and also affect the outcomes of the pathology. Therefore, a targeted and careful control of the intestinal microbiota could represent a complementary intervention to be implemented for the management and the challenge against COVID-19.
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Affiliation(s)
- Giovanna Traina
- Department of Pharmaceutical Sciences, University of Perugia, Via Romana, 06126 Perugia, Italy
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15
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SARS-CoV-2 infects adipose tissue in a fat depot- and viral lineage-dependent manner. Nat Commun 2022; 13:5722. [PMID: 36175400 PMCID: PMC9521555 DOI: 10.1038/s41467-022-33218-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/08/2022] [Indexed: 01/08/2023] Open
Abstract
Visceral adiposity is a risk factor for severe COVID-19, and a link between adipose tissue infection and disease progression has been proposed. Here we demonstrate that SARS-CoV-2 infects human adipose tissue and undergoes productive infection in fat cells. However, susceptibility to infection and the cellular response depends on the anatomical origin of the cells and the viral lineage. Visceral fat cells express more ACE2 and are more susceptible to SARS-CoV-2 infection than their subcutaneous counterparts. SARS-CoV-2 infection leads to inhibition of lipolysis in subcutaneous fat cells, while in visceral fat cells, it results in higher expression of pro-inflammatory cytokines. Viral load and cellular response are attenuated when visceral fat cells are infected with the SARS-CoV-2 gamma variant. A similar degree of cell death occurs 4-days after SARS-CoV-2 infection, regardless of the cell origin or viral lineage. Hence, SARS-CoV-2 infects human fat cells, replicating and altering cell function and viability in a depot- and viral lineage-dependent fashion. Visceral adiposity is a risk factor for severe COVID-19, and infection of adipose tissue by SARS-CoV-2 has been reported. Here the authors confirm that human adipose tissue is a possible site for SARS-CoV-2 infection, but the degree of adipose tissue infection and the way adipocytes respond to the virus depend on the adipose tissue depot and the viral strain.
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16
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Rossi AP, Muollo V, Dalla Valle Z, Urbani S, Pellegrini M, El Ghoch M, Mazzali G. The Role of Obesity, Body Composition, and Nutrition in COVID-19 Pandemia: A Narrative Review. Nutrients 2022; 14:3493. [PMID: 36079751 PMCID: PMC9458228 DOI: 10.3390/nu14173493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has spread worldwide, infecting nearly 500 million people, with more than 6 million deaths recorded globally. Obesity leads people to be more vulnerable, developing worse outcomes that can require hospitalization in intensive care units (ICU). This review focused on the available findings that investigated the link between COVID-19, body composition, and nutritional status. Most studies showed that not only body fat quantity but also its distribution seems to play a crucial role in COVID-19 severity. Compared to the body mass index (BMI), visceral adipose tissue and intrathoracic fat are better predictors of COVID-19 severity and indicate the need for hospitalization in ICU and invasive mechanical ventilation. High volumes of epicardial adipose tissue and its thickness can cause an infection located in the myocardial tissue, thereby enhancing severe COVID-related myocardial damage with impairments in coronary flow reserve and thromboembolism. Other important components such as sarcopenia and intermuscular fat augment the vulnerability in contracting COVID-19 and increase mortality, inflammation, and muscle damage. Malnutrition is prevalent in this population, but a lack of knowledge remains regarding the beneficial effects aimed at optimizing nutritional status to limit catabolism and preserve muscle mass. Finally, with the increase in patients recovering from COVID-19, evaluation and treatment in those with Long COVID syndrome may become highly relevant.
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Affiliation(s)
- Andrea P. Rossi
- Division of Geriatrics, Department of Medicine, Ospedale Cà Foncello, 31100 Treviso, Italy
| | - Valentina Muollo
- Department of Medicine, University of Verona, 37126 Verona, Italy
| | - Zeno Dalla Valle
- Department of Medicine, Geriatrics Division, University of Verona, 37126 Verona, Italy
| | - Silvia Urbani
- Department of Medicine, Geriatrics Division, University of Verona, 37126 Verona, Italy
| | - Massimo Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Marwan El Ghoch
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut P.O. Box 11-5020, Lebanon
| | - Gloria Mazzali
- Department of Medicine, Geriatrics Division, University of Verona, 37126 Verona, Italy
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17
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Steenblock C, Hassanein M, Khan EG, Yaman M, Kamel M, Barbir M, Lorke DE, Everett D, Bejtullah S, Lohmann T, Lindner U, Tahirukaj E, Jirjees FJ, Soliman SS, Quitter F, Bornstein SR. Obesity and COVID-19: What are the Consequences? Horm Metab Res 2022; 54:496-502. [PMID: 35724688 PMCID: PMC9427204 DOI: 10.1055/a-1878-9757] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Obesity is an increasing health problem all over the world. In combination with the current COVID-19 pandemic, this has turned into a massive challenge as individuals with overweight and obesity at all ages show a significant increase in their risk of getting severe COVID-19. Around 20% of all patients that were hospitalized for COVID-19 suffered from obesity alone, whereas obesity in combination with other metabolic comorbidities, such as type 2 diabetes and hypertension, account for up to 60% of all hospitalizations in relation to COVID-19. Therefore, it is of immense importance to put the spotlight on the high incidence of obesity present already in childhood both by changing the individual minds and by encouraging politicians and the whole society to commence preventive interventions for achieving a better nutrition for all social classes all over the world. In the current review, we aim to explain the different pathways and mechanisms that are responsible for the increased risk of severe COVID-19 in people with overweight and obesity. Furthermore, we discuss how the pandemic has led to weight gains in many people during lockdown. At the end, we discuss the importance of preventing such an interface between a non-communicable disease like obesity and a communicable disease like COVID-19 in the future.
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Affiliation(s)
- Charlotte Steenblock
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
- Correspondence Dr. Charlotte Steenblock University Hospital Carl Gustav Carus, Technische Universität
Dresden, Department of Medicine IIIFetscherstraße 7401307 DresdenGermany+493514586130+493514586398
| | - Mohamed Hassanein
- Department of Diabetes and Endocrinology, Dubai Hospital, Dubai, United
Arab Emirates
| | - Emran G. Khan
- Endocrinology and Diabetology, King’s College Hospital London,
Dubai, United Arab Emirates
| | - Mohamad Yaman
- Building 6, Nesmah Technology, Dubai, United Arab
Emirates
| | - Margrit Kamel
- Center for Regenerative Therapies Dresden, Technische Universitat
Dresden, Dresden, Germany
| | - Mahmoud Barbir
- Department of Cardiology, Harefield Hospital, Harefield, United Kingdom
of Great Britain and Northern Ireland
| | - Dietrich E. Lorke
- Department of Anatomy and Cellular Biology, Khalifa University, Abu
Dhabi, United Arab Emirates
| | - Dean Everett
- Department of Pathology and Infectious Diseases, Khalifa University,
Abu Dhabi, United Arab Emirates
| | | | | | - Uwe Lindner
- Internal Medicine II, Klinikum Chemnitz, Chemnitz,
Germany
| | - Ermal Tahirukaj
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
| | | | - Sameh S.M. Soliman
- College of Pharmacy, University of Sharjah, Sharjah, United Arab
Emirates
| | - Friederike Quitter
- Klinik für Kinder- und Jugendmedizin,
Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Stefan R. Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav
Carus, Dresden, Germany
- School of Cardiovascular and Metabolic Medicine and Sciences, Faculty
of Life Sciences & Medicine, King’s College London, London,
UK
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18
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Cinti F, Cinti S. The Endocrine Adipose Organ: A System Playing a Central Role in COVID-19. Cells 2022; 11:cells11132109. [PMID: 35805193 PMCID: PMC9265618 DOI: 10.3390/cells11132109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
In the last 30 years the adipose cell has been object of several studies, turning its reputation from an inert cell into the main character involved in the pathophysiology of multiple diseases, including the ongoing COVID-19 pandemic, which has changed the clinical scenario of the last two years. Composed by two types of tissue (white and brown), with opposite roles, the adipose organ is now classified as a real endocrine organ whose dysfunction is involved in different diseases, mainly obesity and type 2 diabetes. In this mini-review we aim to retrace the adipose organ history from physiology to physiopathology, to provide therapeutic perspectives for the prevention and treatment of its two main related diseases (obesity and type 2 diabetes) and to summarize the most recent discoveries linking adipose tissue to COVID-19.
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Affiliation(s)
- Francesca Cinti
- UOS Centro Malattie Endocrine e Metaboliche, UOC Endocrinologia e Diabetologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy;
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Saverio Cinti
- Center of Obesity, Department of Experimental and Clinical Medicine, Marche Polytechnic University, 60126 Ancona, Italy
- Correspondence: or ; Tel.: +39-3396936172
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19
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Palma G, Sorice GP, Genchi VA, Giordano F, Caccioppoli C, D’Oria R, Marrano N, Biondi G, Giorgino F, Perrini S. Adipose Tissue Inflammation and Pulmonary Dysfunction in Obesity. Int J Mol Sci 2022; 23:ijms23137349. [PMID: 35806353 PMCID: PMC9267094 DOI: 10.3390/ijms23137349] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023] Open
Abstract
Obesity is a chronic disease caused by an excess of adipose tissue that may impair health by altering the functionality of various organs, including the lungs. Excessive deposition of fat in the abdominal area can lead to abnormal positioning of the diaphragm and consequent reduction in lung volume, leading to a heightened demand for ventilation and increased exposure to respiratory diseases, such as chronic obstructive pulmonary disease, asthma, and obstructive sleep apnoea. In addition to mechanical ventilatory constraints, excess fat and ectopic deposition in visceral depots can lead to adipose tissue dysfunction, which promotes metabolic disorders. An altered adipokine-secretion profile from dysfunctional adipose tissue in morbid obesity fosters systemic, low-grade inflammation, impairing pulmonary immune response and promoting airway hyperresponsiveness. A potential target of these adipokines could be the NLRP3 inflammasome, a critical component of the innate immune system, the harmful pro-inflammatory effect of which affects both adipose and lung tissue in obesity. In this review, we will investigate the crosstalk between adipose tissue and the lung in obesity, highlighting the main inflammatory mediators and novel therapeutic targets in preventing pulmonary dysfunction.
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20
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Pandolfi S, Valdenassi L, Bjørklund G, Chirumbolo S, Lysiuk R, Lenchyk L, Doşa MD, Fazio S. COVID-19 Medical and Pharmacological Management in the European Countries Compared to Italy: An Overview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4262. [PMID: 35409942 PMCID: PMC8998583 DOI: 10.3390/ijerph19074262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/16/2022] [Accepted: 03/30/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: Italy accounts for more than 150,000 deaths due to the COVID-19 pandemic, leading the top rank in SARS-CoV-2-caused deceases in Europe. A survey on the different ways by which the COVID-19 pandemic emergency was managed in the foreign European countries compared to Italy is the purpose of this paper. (2) Methods: A literature search and various mathematical algorithms to approach a rank scoring scale were used to describe in detail the different approaches used by European countries to manage the COVID-19 pandemic emergency. (3) Results: The study showed that Italy stands at the bottom ranking for COVID-19 management due to its high mortality rate. Possible causes of the observed huge numbers of hospitalization and deaths were (a) the demographic composition of the European country; (b) its decentralized healthcare system organization; (c) the role of correct pharmacology in the early stages before hospitalization. Post-mortem examinations were of paramount importance to elucidate the etiopathogenesis of COVID-19 and to tailor a suitable and proper therapy in the early symptomatic stages of COVID-19, preventing hospitalization. (4) Conclusions: Factors such as the significant impact on elderly people, the public health organization prevalently state-owned and represented mainly by hospitals, and criticism of the home therapy approach toward SARS-CoV-2-infected people, may have concurred in increasing the number of COVID-19 deaths in Italy.
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Affiliation(s)
- Sergio Pandolfi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (S.P.); (L.V.)
| | - Luigi Valdenassi
- High School Master of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (S.P.); (L.V.)
| | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway;
| | - Salvatore Chirumbolo
- Council for Nutritional and Environmental Medicine (CONEM), 8610 Mo i Rana, Norway;
| | - Roman Lysiuk
- Department of Pharmacognosy and Botany, Danylo Halytsky Lviv National Medical University, 79010 Lviv, Ukraine;
| | - Larysa Lenchyk
- Department of Standardization Kharkiv, National University of Pharmacy, 61002 Kharkiv, Ukraine;
| | - Monica Daniela Doşa
- Department of Pharmacology, Faculty of Medicine, Ovidius University, 900527 Constanța, Romania;
| | - Serafino Fazio
- Department of Internal Medicine, University of Naples Federico II, 80138 Naples, Italy;
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Guglielmi V, El Ghoch M, Bettini S, Holly JMP. Editorial: Covid-19 and obesity. Front Endocrinol (Lausanne) 2022; 13:1122274. [PMID: 36619552 PMCID: PMC9817024 DOI: 10.3389/fendo.2022.1122274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Affiliation(s)
- Valeria Guglielmi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Internal Medicine Unit - Obesity Center, University Hospital Policlinico Tor Vergata, Rome, Italy
- *Correspondence: Valeria Guglielmi,
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Silvia Bettini
- Center for the Study and the Integrated Treatment of Obesity, Internal Medicine 3, Padua University Hospital, Padua, Italy
| | - Jeff M. P. Holly
- Faculty of Medicine, School of Translational Health Science, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, United Kingdom
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