Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic
Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic
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DOI：
10.1007/s00592-020-01522-8
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发表时间：
2020-04-05
影响因子：
3.8
通讯作者：
Radaelli, Maria Grazia
中科院分区：
文献类型：
--
作者：
Luzi, Livio;Radaelli, Maria Grazia
目的 分析肥胖与流感之间的关系。方法基础激素环境、先天性和适应性免疫系统反应缺陷以及久坐是肥胖患者流感病毒感染严重程度的主要决定因素。超重不仅会增加单个肥胖者感染和并发症的风险，而且人群中肥胖者的大量患病可能会增加出现毒性更强的病毒株的机会，延长病毒在整个人群中的传播时间，最终可能会增加流感大流行的总体死亡率。结果等待针对 COVID-19 的疫苗研发，隔离阳性病例和保持社交距离是主要干预措施。尽管如此，以往流感大流行的证据表明，可以采取以下干预措施来改善免疫反应：（1）通过轻度限制热量来减轻体重； (2)将AMPK激活剂和PPARγ激活剂纳入糖尿病相关肥胖的药物治疗中； (3)进行轻度至中度的体育锻炼。结论 由于病毒脱落时间较长，肥胖受试者的隔离时间可能比正常体重个体更长。
Aims Analyze the relationship between obesity and influenza. Methods Basal hormone milieu, defective response of both innate and adaptive immune system and sedentariness are major determinants in the severity of influenza viral infection in obese patients. Being overweight not only increases the risk of infection and of complications for the single obese person, but a large prevalence of obese individuals within the population might increase the chance of appearance of more virulent viral strain, prolongs the virus shedding throughout the total population and eventually might increase overall mortality rate of an influenza pandemic. Results Waiting for the development of a vaccination against COVID-19, isolation of positive cases and social distancing are the primary interventions. Nonetheless, evidence from previous influenza pandemics suggests the following interventions aimed at improving immune response: (1) lose weight with a mild caloric restriction; (2) include AMPK activators and PPAR gamma activators in the drug treatment for obesity associated with diabetes; and (3) practice mild-to-moderate physical exercise. Conclusions Due to prolonged viral shedding, quarantine in obese subjects should likely be longer than normal weight individuals.