The growing pandemic of the disease of the new Coronavirus 2019 (COVID-19), caused by the severe respiratory syndrome Severo Coronavirus 2 (SARS-COV-2), has become an in an evolving world health crisis. With the increase in the prevalence of obesity and diabetes, the awareness of its impacts on infectious-counts, knowing that there is a greater risk for the development of various infections, complications after them and mortality For critical infections.
The Covid-19 pandemic is extending rapidly worldwide, especially in Europe and North America, where obesity is very prevalent. Although the epidemiological and clinical characteristics of the COVID-19 have been constantly informed, the relationship between obesity and acute respiratory syndrome CORONAVIRUS-2 (SARS-COV-2) has not been completely documented until a few months ago, so that Numerous scientific studies have focused their objectives in determining whether there is a greater frequency of obesity among patients admitted to intensive care units by SARS-COV-2. Multiple scientific publications that are seeing light in recent weeks have established that the seriousness of the disease by Coronavirus increases with the BMI (body mass index).Obesity has proven to be a risk factor for the seriousness of the SARS-COV-2 and therefore requires greater attention to preventive measures in susceptible people.
Obesity plays an important role in the pathogenesis of Covid-19 infection. In fact, the immune system, which is a key actor in the pathogenesis of Covid-19, also plays an important role in inflammation of adipose tissue induced by obesity.
In diabetes, chronic exposure to an abnormal metabolic environment can lead to alterations of innate and adaptive immunity, aggravating the inflammatory waterfall and causing anomalies in pulmonary physiology and therefore increasing the infectivity and virulence of the coronavirus. Obesity and SARS-COV-2 share common elements of the inflammatory process (and possibly also metabolic alterations), which aggravates SARS-COV-2 infection in obese.
Severe obesity (BMI ≥ 35 kg / m 2) has proven to increase the risk of entry into ICU, while the history of heart disease and obesity (BMI ≥ 30 kg / m 2) are independently associated with the use of mechanical ventilation invasive Greater surveillance and aggressive treatment of patients with obesity and COVID-19 is justified.
Since it has been shown that obesity increases vulnerability to infections, it can be a mortality risk factor related to COVID - 19. This is even more true since there are no specific clinical signs that presume the progression of a mild infection by a mild infection COVID-19 to a serious way. Compared to non-obese patients, BMI was significantly higher in patients with a serious form of COVID-19 infection.
Therefore, we recommend additional care and precautions for patients with obesity during this epidemic. Whenever a COVID-19 infection is suspected, the screening should be systematic, especially if the patient has obesity.
Dra.Vanesa Maturana – HLAHERMOSA GENERAL SURGERY
