Peer-Reviewed Journal Details
Mandatory Fields
Ryan, Paul MacDaragh; Caplice, Noel M.
Obesity (Silver Spring, Md.)
Is adipose tissue a reservoir for viral spread, immune activation and cytokine amplification in COVID-19?
Optional Fields
Obesity Poor COVID-19 outcome Adipose tissue Cytokine pathways Cytokine amplification
Coronavirus disease 2019 (COVID-19), the worst pandemic in more than a century, has claimed >125,000 lives worldwide to date. Emerging predictors for poor outcome include advanced age, male gender, pre-existing cardiovascular disease and risk factors including hypertension, diabetes and more recently obesity. Herein, we posit new obesity-driven predictors of poor COVID-19 outcome, over and above the more obvious extant risks associated with obesity including cardiometabolic disease and hypoventilation syndrome in intensive care patients. We outline a theoretical mechanistic framework whereby adipose tissue in subjects with obesity may act as a reservoir for more extensive viral spread with increased shedding, immune activation and cytokine amplification. We propose studies to test this reservoir concept with a focus on specific cytokine pathways that might be amplified in subjects with obesity and COVID-19. Finally, we underscore emerging therapeutic strategies that might benefit subsets of patients in which cytokine amplification is excessive and potentially fatal.
Grant Details