Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning.
Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning.
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DOI：
10.1016/j.cmet.2021.01.016
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发表时间：
2021-03-02
期刊：
影响因子：
29
通讯作者：
Drucker DJ
中科院分区：
文献类型：
--
作者：
Drucker DJ
患有严重 COVID-19 疾病的住院患者中肥胖、糖尿病和心血管危险因素的患病率不断增加，引起了人们对 SARS-CoV-2 诱导的病理生理学代谢方面的极大兴趣。在这里，我更新了一些概念，介绍代谢紊乱及其合并症如何改变 SARS-CoV-2 感染的易感性、自然史和潜在治疗方法，重点关注人类生物学。重点介绍了肥胖和糖尿病患者的遗传易感性、流行病学、免疫反应、疾病严重程度和 COVID-19 治疗的新数据。综述了代谢紊乱与病毒诱导的免疫反应和病毒持续存在之间的新关系，以及脂肪和胰岛 ACE2 表达、血糖控制、胆固醇代谢以及降糖降脂药物的假定重要性，并关注争议和未解决的问题。这些领域的快速进展使我们对糖尿病和肥胖症患者的 SARS-CoV-2 感染有了越来越多的了解，同时完善了这一弱势群体的治疗策略和研究重点。 COVID-19 感染会导致肥胖或糖尿病患者死亡率过高。在此，我们回顾代谢紊乱和 SARS-CoV-2 感染者的流行病学、感染易感性、病理生理学、免疫学、并发症、潜在治疗方案以及疫苗接种反应。
The increased prevalence of obesity, diabetes, and cardiovascular risk factors in people hospitalized with severe COVID-19 illness has engendered considerable interest in the metabolic aspects of SARS-CoV-2-induced pathophysiology. Here, I update concepts informing how metabolic disorders and their co-morbidities modify the susceptibility to, natural history, and potential treatment of SARS-CoV-2 infection, with a focus on human biology. New data informing genetic predisposition, epidemiology, immune responses, disease severity, and therapy of COVID-19 in people with obesity and diabetes are highlighted. The emerging relationships of metabolic disorders to viral-induced immune responses and viral persistence, and the putative importance of adipose and islet ACE2 expression, glycemic control, cholesterol metabolism, and glucose- and lipid-lowering drugs is reviewed, with attention to controversies and unresolved questions. Rapid progress in these areas informs our growing understanding of SARS-CoV-2 infection in people with diabetes and obesity, while refining the therapeutic strategies and research priorities in this vulnerable population. COVID-19 infection produces excess mortality in people with obesity or diabetes. Here we review the epidemiology, susceptibility to infection, pathophysiology, immunology, complications, potential therapeutic options, and response to vaccinations in people with metabolic disorders and SARS-CoV-2 infection.
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DOI：
10.1186/s13054-020-03323-5
发表时间：
2020-10-16
期刊：
Critical care (London, England)
影响因子：
--
作者：
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通讯作者：
Timsit JF
影响因子：
5
作者：
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通讯作者：
Klonoff, David C.
影响因子：
7.7
作者：
Batchu, Sri Nagarjun;Kaur, Harmandeep;Advani, Andrew
通讯作者：
Advani, Andrew
影响因子：
8.2
作者：
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通讯作者：
Gourdy, Pierre
影响因子：
3.8
作者：
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通讯作者：
Qiao, Jian