In a Nature Reviews Endocrinology "Comment" authors from the German Center for Diabetes Research (DZD), the Boston Children's Hospital and the Harvard T.H. Chan School of Public Health call for more research about the relationships of obesity, disproportionate fat distribution and impaired metabolic health with the severity of COVID-19.
The authors raise the point that most of the studies that have reported comorbidities in patients with COVID-19 did not provide data on body weight and height, which are used to estimate adipose tissue mass, by calculating the BMI. In their Comment they also briefly summarize novel research findings, deriving in part from articles which have not yet undergone peer-review, indicating that overweight and, particularly, obesity may associate with a substantial risk of a severe course of COVID-19. Importantly, these studies suggest that this risk is independent of cardiometabolic diseases and other comorbidities.
The authors then discuss possible mechanisms explaining this relationship. Among them respiratory dysfunction in obesity may result in hypoventilation-associated pneumonia and hypoxia-induced cardiac stress. Furthermore, they highlight that not only the calculation of the BMI, but also the measurement of the waist circumference and of glucose and insulin levels, which can be used to determine the presence of prediabetes and insulin resistance, may be important, as these parameters are independent determinants of cardiometabolic diseases, pneumonia and mortality.
Stefan N, Birkenfeld AL, Schulze MB, Ludwig DS. Obesity and impaired metabolic health in patients with COVID-19. Nat Rev Endocrinol. 2020, doi.org/10.1038/s41574-020-0364-6
Prof. Dr. med. Norbert Stefan
German Center for Diabetes Research
Department of Internal Medicine IV
Tübingen University Hospital
Otfried-Müller-Str. 10, 72076 Tübingen, Germany
Phone: +49 (0)7071 29-80390
The German Center for Diabetes Research (DZD) is one of six German Centers for Health Research. It brings together experts in the field of diabetes research and integrates basic research, epidemiology, and clinical applications. By adopting an innovative, integrative approach to research, the DZD aims to make a substantial contribution to the successful personalized prevention, diagnosis and treatment of diabetes mellitus. The members of the DZD are Helmholtz Zentrum München - German Research Center for Environmental Health, the German Diabetes Center (DDZ) in Düsseldorf, the German Institute of Human Nutrition (DIfE) in Potsdam-Rehbrücke, the Institute of Diabetes Research and Metabolic Diseases of Helmholtz Zentrum München at the University of Tübingen, the Paul Langerhans Institute Dresden of Helmholtz Zentrum München at the Carl Gustav Carus University Hospital of TU Dresden, associated partners at the universities in Heidelberg, Cologne, Leipzig, Lübeck and Munich, and other project partners. http://www.dzd-ev.de/en
Nature Reviews Endocrinology