Global pandemics interconnected - obesity, impaired metabolic health and COVID-19.
21 Jan 2021-Nature Reviews Endocrinology (Springer Science and Business Media LLC)-Vol. 17, Iss: 3, pp 135-149
TL;DR: In this paper, the authors highlight how obesity and impaired metabolic health increase complications and mortality in COVID-19 and summarize the consequences of SARS-CoV-2 infection for organ function and risk of NCDs.
Abstract: Obesity and impaired metabolic health are established risk factors for the non-communicable diseases (NCDs) type 2 diabetes mellitus, cardiovascular disease, neurodegenerative diseases, cancer and nonalcoholic fatty liver disease, otherwise known as metabolic associated fatty liver disease (MAFLD). With the worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), obesity and impaired metabolic health also emerged as important determinants of severe coronavirus disease 2019 (COVID-19). Furthermore, novel findings indicate that specifically visceral obesity and characteristics of impaired metabolic health such as hyperglycaemia, hypertension and subclinical inflammation are associated with a high risk of severe COVID-19. In this Review, we highlight how obesity and impaired metabolic health increase complications and mortality in COVID-19. We also summarize the consequences of SARS-CoV-2 infection for organ function and risk of NCDs. In addition, we discuss data indicating that the COVID-19 pandemic could have serious consequences for the obesity epidemic. As obesity and impaired metabolic health are both accelerators and consequences of severe COVID-19, and might adversely influence the efficacy of COVID-19 vaccines, we propose strategies for the prevention and treatment of obesity and impaired metabolic health on a clinical and population level, particularly while the COVID-19 pandemic is present.
Citations
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TL;DR: In this article , the authors discuss the major mechanisms that are involved in the pathogenesis of NAFLD and type 2 diabetes, and discuss whether these mechanisms place NA FLD in an important position to better understand the pathogenic of NCDs and communicable diseases, such as COVID-19.
146 citations
Dresden University of Technology1, Monash University2, Moscow State University3, Saint Petersburg State University4, Technische Universität München5, University of Leicester6, King's College London7, Nanyang Technological University8, University of Southampton9, University of Miami10, University of Amsterdam11, University of Montpellier12, Anschutz Medical Campus13, Imperial College London14, State University of Campinas15, The Chinese University of Hong Kong16, University of Yaoundé17, University of Nigeria, Nsukka18, Baqai Medical University19, Gulf Medical University20, University of Zurich21, Agostino Gemelli University Polyclinic22
TL;DR: In this paper, the authors provide an update on the mechanisms of how metabolic and endocrine disorders might predispose patients to develop severe COVID-19 and post-pandemic.
119 citations
TL;DR: In this paper , a wearable electrochemical biosensor for the continuous analysis, in sweat during physical exercise and at rest, of trace levels of multiple metabolites and nutrients, including all essential amino acids and vitamins.
Abstract: Wearable non-invasive biosensors for the continuous monitoring of metabolites in sweat can detect a few analytes at sufficiently high concentrations, typically during vigorous exercise so as to generate sufficient quantity of the biofluid. Here we report the design and performance of a wearable electrochemical biosensor for the continuous analysis, in sweat during physical exercise and at rest, of trace levels of multiple metabolites and nutrients, including all essential amino acids and vitamins. The biosensor consists of graphene electrodes that can be repeatedly regenerated in situ, functionalized with metabolite-specific antibody-like molecularly imprinted polymers and redox-active reporter nanoparticles, and integrated with modules for iontophoresis-based sweat induction, microfluidic sweat sampling, signal processing and calibration, and wireless communication. In volunteers, the biosensor enabled the real-time monitoring of the intake of amino acids and their levels during physical exercise, as well as the assessment of the risk of metabolic syndrome (by correlating amino acid levels in serum and sweat). The monitoring of metabolites for the early identification of abnormal health conditions could facilitate applications in precision nutrition.
89 citations
TL;DR: In this paper, the role of genes, early-life exposures, and lifestyle risk factors in the cause of Type 2 diabetes is discussed, with an emphasis on populations in current hotspots of the epidemic, and potential impacts of the coronavirus disease 2019 pandemic and T2D prevention policies and action.
80 citations
Icahn School of Medicine at Mount Sinai1, University of Colorado Denver2, Rusk Institute of Rehabilitation Medicine3, Johns Hopkins University4, University of North Carolina at Chapel Hill5, Spaulding Rehabilitation Hospital6, University of Texas Health Science Center at San Antonio7, Beth Israel Deaconess Medical Center8, Oregon Health & Science University9, University of Pennsylvania10
TL;DR: The American Academy of Physical Medicine and Rehabilitation (AAPM&R) Multi-Disciplinary PASC Collaborative as discussed by the authors developed consensus guidance on assessment and treatment recommendations for a series of Consensus Guidance Statements focused on the most prominent PASC symptoms.
Abstract: Large numbers of individuals who have been infected with SARS‐CoV‐2, the virus responsible for COVID‐19, continue to experience a constellation of symptoms long past the time that they have recovered from the acute stages of their illness. Often referred to as “long COVID,” these symptoms, which can include fatigue, shortness of breath, palpitations, cognitive dysfunction (“brain fog”), sleep disorders, fevers, gastrointestinal symptoms, anxiety, depression, and others, can persist for months and can range from mild to incapacitating. Although still being defined, these effects can be collectively referred to as postacute sequelae of SARS‐CoV‐2 infection (PASC).1 The magnitude of this problem is not yet known, but given the millions of individuals worldwide who have had, or will have, COVID‐19, the societal impacts are likely to be profound and long lasting.2, 3, 4, 5
It is widely acknowledged that systematic study is needed to develop an evidence‐based approach for caring for patients with PASC. At present, there is a dearth of rigorous scientific evidence regarding effective assessment and treatment of PASC that prevents the creation of evidence‐based clinical guidelines. However, the U.S. health system is currently seeing an increase in the number of patients presenting with PASC, and there is an urgent need for clinical guidance in treating these patients. The goal of this, and future statements, is to provide practical guidance to clinicians in the assessment and treatment of patients presenting with PASC.
This Consensus Guidance Statement on fatigue is the first of a series focused on the most prominent PASC symptoms.
PASC consensus guidance statement methods
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) Multi‐Disciplinary PASC Collaborative (“PASC Collaborative”) was created, in part, to develop expert recommendations and guidance from established PASC centers with extensive experience in managing patients with PASC. The PASC Collaborative is following an iterative, development approach to achieve consensus on assessment and treatment recommendations for a series of Consensus Guidance Statements focused on the most prominent PASC symptoms. These statements were developed by a diverse team of experts, with input from patient representatives with a history of PASC, and integrate current experience and expertise with available evidence to provide tools to clinicians treating patients. There is an intentional focus on health equity as disparities in care and outcomes are critically important to address. Beyond patient care, the hope is that a broadened understanding of current patient care practices will help identify areas of future research. A full description of the methodology is also published in this issue.6
We acknowledge that the definition of PASC is evolving, and there are various factors that contribute to diagnosis. The PASC Collaborative sought input from patient representatives with a history of PASC and patient‐led research initiatives to inform recommendations. For example, previous literature has suggested that PASC be defined as the continuation of symptoms beyond 3 or 4 weeks from the onset of acute infection.7 Other definitions of PASC include symptoms lasting longer than 3 months.8 Based on feedback of patient representatives that earlier evaluation, diagnosis, and management can improve access to beneficial interventions, for the purpose of this Consensus Guidance Statement, we recommend expanded assessment if symptoms are not improving 1 month after acute symptom onset.
These Consensus Guidance Statements are intended to reflect current practice in patient assessment, testing, and treatments. They should not preclude clinical judgment and must be applied in the context of the specific patient, with adjustments for patient preferences, comorbidities, and other factors.
60 citations
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