La colisión de dos pandemias: retos y oportunidades

• Luis Masmiquel Comas ^[1]
  1. [1] Servicio de Endocrinología y Nutrición. Hospital Universitario Son Llàtzer. IdISBa
• Localización: Academic Journal of Health Sciences: Medicina Balear, ISSN-e 2255-0560, Vol. 36, Nº. 2, 2021, págs. 111-121
• Idioma: español
• DOI: 10.3306/AJHS.2021.36.02.111
• Títulos paralelos:
  • The collision of two pandemics: challenges and opportunities
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Se revisan los datos epidemiológicos, fisiopatológicos y clínicos que permiten afirmar que la COVID-19 ha entrado en colisión con la gran pandemia de obesidad. La obesidad implica un aumento del riesgo de infección y multiplica las posibilidades de mala evolución y muerte por COVID-19. También, al igual que la COVID-19, supone una carga económica y sociosanitaria de primera magnitud.

    Reconocer el impacto de la obesidad sobre la COVID-19 implica retos y oportunidades en ámbitos que abarcan desde la investigación y la prevención hasta el tratamiento ambulatorio y hospitalario de ambas entidades. Por otra parte, debemos admitir que la interrelación obesidad-COVID-19 es compleja y subyace sobre determinantes sociales de salud.

    Así pues, para entender y abordar COVID-19 deberemos abordar la obesidad y sus derivadas; es decir, otras enfermedades no comunicables como la diabetes, las enfermedades cardiovasculares, las enfermedades respiratorias crónicas y el cáncer. También, deberemos articular políticas y programas que reviertan las desigualdades. Realizar esfuerzos en esta línea sin duda mejorará nuestra salud e incrementará nuestra resiliencia frente a amenazas futuras.

  • English

    The epidemiological, pathophysiological and clinical data that allow us to affirm that COVID-19 has collided with the great pandemic of obesity are reviewed. Obesity confers an increased risk of infection and multiplies the chances of poor evolution and death from COVID-19. Also, like COVID-19, it supposes an economic, health and social burden of the first magnitude. Recognizing the impact of obesity on COVID-19 implies challenges and opportunities in areas ranging from research and prevention to outpatient and hospital treatment of both entities. On the other hand, we must admit that the obesity-COVID-19 interrelation underlies social determinants of health that substantially increase its toll. Thus, to understand and address COVID-19 we must address obesity and its derivatives; that is, other non-communicable diseases such as diabetes, cardiovascular diseases, chronic respiratory diseases and cancer. Also, we must articulate policies and programs that reverse inequalities. Making efforts in this line will undoubtedly improve our health and increase our resilience against future threats.

• Referencias bibliográficas
  • https://www.who.int/es/news/item/27-04-2020-who-timeline---covid-19.
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao...
  • Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; the Northwell COVID-19 Research Consortium, Barnaby...
  • Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, Cereda D, Coluccello A, Foti G, Fumagalli R, ...
  • Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, Holden KA, Read JM, Dondelinger F, Carson G, Merson L, Lee ...
  • https://coronavirus.jhu.edu/map.html. Acceso 30 de diciembre de 2020
  • Masmiquel L. Obesidad: visión actual de una enfermedad crónica (Obesity as a chronic disease: current approach). Medicina...
  • Luzi L, Radaelli MG. Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic. Acta Diabetol. 2020 Jun;57(6):759-764....
  • Cai Q, Chen F, Wang T, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care 2020;43:1392–1398....
  • Simonnet A, Chetboun M, Poissy J, Raverdy V, Noulette J, Duhamel A, Labreuche J, Mathieu D, Pattou F, Jourdain M; LICORN and the...
  • Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, Tobin KA, Cerfolio RJ, Francois F, Horwitz LI. Factors associated...
  • Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, Stachel A. Obesity in Patients Younger Than 60 Years Is a...
  • Hendren NS, de Lemos JA, Ayers C, Das SR, Rao A, Carter S, Rosenblatt A, Walchok JG, Omar W, Khera R, Hegde AA, Drazner...
  • Popkin BM, Du S, Green WD, Beck MA, Algaith T, Herbst CH, Alsukait RF, Alluhidan M, Alazemi N, Shekar M. Individuals ...
  • Yates T, Razieh C, Zaccardi F, Davies MJ, Khunti K. Obesity and risk of COVID-19: analysis of UK biobank. Prim Care Diabetes....
  • Aung N, Khanji MY, Munroe PB, Petersen SE. Causal Inference for Genetic Obesity, Cardiometabolic Profile and COVID-19 Susceptibility: A ...
  • Independent Expert Group of the Global Nutrition Report. 2020 Global nutrition report: action on equity to end malnutrition. Development...
  • Kantar. Covid-19: wave 2, 27-30 March among connected South African consumers. Kantar World Panel: Johannisberg 2020.
  • Euromonitor Passport . The impact of coronavirus on packaged and fresh food. Euromonitor International London 2020.
  • Pries AM, Ferguson EL, Sharma N, Upadhyay A, Filteau S. Exploratory Analysis of Nutritional Quality and Metrics of...
  • Talbot HK, Coleman LA, Crimin K, Zhu Y, Rock MT, Meece J, Shay DK, Belongia EA, Griffin MR. Association between obesity...
  • Rosen ED, Spiegelman BM. What we talk about when we talk about fat. Cell. 2014 Jan 16;156(1-2):20-44. doi: 10.1016/j.cell.2013.12.012. PMID:...
  • Khan S, Chan YT, Revelo XS, Winer DA. The Immune Landscape of Visceral Adipose Tissue During Obesity and Aging. Front Endocrinol (Lausanne)....
  • Sheridan PA, Paich HA, Handy J, Karlsson EA, Hudgens MG, Sammon AB, Holland LA, Weir S, Noah TL, Beck MA. Obesity is...
  • Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS....
  • Mahallawi WH, Khabour OF, Zhang Q, Makhdoum HM, Suliman BA. MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17...
  • Wong CK, Lam CW, Wu AK, Ip WK, Lee NL, Chan IH, Lit LC, Hui DS, Chan MH, Chung SS, Sung JJ. Plasma inflammatory cytokines and chemokines ...
  • Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine...
  • Goossens GH. The renin-angiotensin system in the pathophysiology of type 2 diabetes. Obes Facts. 2012;5(4):611-24....
  • Ferrario CM, Strawn WB. Role of the renin-angiotensin-aldosterone system and proinflammatory mediators in cardiovascular disease. Am J Cardiol....
  • Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A, Müller MA,...
  • Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, Wang Z, Li J, Li J, Feng C, Zhang Z, Wang L, Peng L, Chen L, Qin Y, Zhao D, Tan S, Yin L,...
  • Ryan PM, Caplice NM. Is Adipose Tissue a Reservoir for Viral Spread, Immune Activation, and Cytokine Amplification in Coronavirus Disease...
  • Deng SQ, Peng HJ. Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China. J Clin Med. 2020 Feb ...
  • Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, Bi Z, Zhao Y. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in...
  • Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY)....
  • Zhu L, She ZG, Cheng X, Qin JJ, Zhang XJ, Cai J, Lei F, Wang H, Xie J, Wang W, Li H, Zhang P, Song X, Chen X, Xiang M, Zhang C, Bai L, Xiang...
  • New York State Department of Health. Fatalities. https:// covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/ NYSDOHCOVID-19Tracker-Fatalities?%3Aembed¼yes&%...
  • Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol. 2020...
  • COVID-19 Surveillance Group. Characteristics of COVID-19 patients dying in Italy Report based on available data on April...
  • Sachdeva S, Khandait H, Kopel J, Aloysius MM, Desai R, Goyal H. NAFLD and COVID-19: a Pooled Analysis. SN Compr Clin Med. 2020 Nov 6:1-4....
  • Wichmann D, Sperhake JP, Lütgehetmann M, Steurer S, Edler C, Heinemann A, Heinrich F, Mushumba H, Kniep I, Schröder AS, Burdelski C, de Heer...
  • Samad F, Ruf W. Inflammation, obesity, and thrombosis. Blood. 2013 Nov 14;122(20):3415-22. doi: 10.1182/blood-2013-05-427708. Epub...
  • Barazzoni R, Bischoff S, Boirie Y, Busetto L, Cederholm T, Dicker D, Toplak H, Van Gossum A, Yumuk V, Vettor R. Sarcopenic Obesity: Time ...
  • de la Rica R, Borges M, Aranda M, Del Castillo A, Socias A, Payeras A, Rialp G, Socias L, Masmiquel L, Gonzalez-Freire M. Low Albumin Levels...
  • Nicolau J, Ayala L, Sanchís P, Olivares J, Dotres K, Soler AG, Rodríguez I, Gómez LA, Masmiquel L. Influence of Nutritional...
  • Palaniswamy S, Gill D, De Silva NM, Lowry E, Jokelainen J, Karhu T, Mutt SJ, Dehghan A, Sliz E, Chasman DI, Timonen M, Viinamäki...
  • Grant WB, Lahore H, Rockwell MS. The Benefits of Vitamin D Supplementation for Athletes: Better Performance and Reduced ...
  • Carter SJ, Baranauskas MN, Fly AD. Considerations for Obesity, Vitamin D, and Physical Activity Amid the COVID-19 Pandemic. Obesity...
  • Huang JF, Wang XB, Zheng KI, Liu WY, Chen JJ, George J, Zheng MH. Letter to the Editor: Obesity hypoventilation syndrome and severe...
  • Jones RL, Nzekwu MM. The effects of body mass index on lung volumes. Chest. 2006 Sep;130(3):827-33. doi: 10.1378/chest.130.3.827....
  • McCallister JW, Adkins EJ, O’Brien JM Jr. Obesity and acute lung injury. Clin Chest Med. 2009 Sep;30(3):495-508, viii. doi: 10.1016/j.ccm.2009.05.008....
  • Spelta F, Fratta Pasini AM, Cazzoletti L, Ferrari M. Body weight and mortality in COPD: focus on the obesity paradox. Eat Weight...
  • Almond MH, Edwards MR, Barclay WS, Johnston SL. Obesity and susceptibility to severe outcomes following respiratory viral infection....
  • Belanger MJ, Hill MA, Angelidi AM, Dalamaga M, Sowers JR, Mantzoros CS. Covid-19 and Disparities in Nutrition and Obesity. N Engl...
  • Horton R. Offline: COVID-19 is not a pandemic. Lancet. 2020 Sep 26;396(10255):874. doi: 10.1016/S0140-6736(20)32000-6. PMID: 32979964;...
  • Chairat K, Jittamala P, Hanpithakpong W, Day NP, White NJ, Pukrittayakamee S, Tarning J. Population pharmacokinetics of oseltamivir...
  • Ferron PJ, Gicquel T, Mégarbane B, Clément B, Fromenty B. Treatments in Covid-19 patients with pre-existing metabolic dysfunction-associated...
  • Huang CJ, Acevedo EO, Mari DC, Randazzo C, Shibata Y. Glucocorticoid inhibition of leptin- and lipopolysaccharide-induced...
  • Center for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus...
  • Gurwitz D. Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. Drug Dev Res. 2020 Aug;81(5):537-540. doi: 10.1002/ddr.21656....
  • Lannelli A, Bouam S, Schneck AS, Frey S, Zarca K, Gugenheim J, Alifano M. The Impact of Previous History of Bariatric Surgery on Outcome of...
  • Aminian A, Fathalizadeh A, Tu C, Butsch WS, Pantalone KM, Griebeler ML, Kashyap SR, Rosenthal RJ, Burguera B, Nissen SE. Association of prior...
  • Naja F, Hamadeh R. Nutrition amid the COVID-19 pandemic: a multi-level framework for action. Eur J Clin Nutr. 2020 Aug;74(8):1117-1121....
  • Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to...
  • Mitchell F. Vitamin-D and COVID-19: do deficient risk a poorer outcome? Lancet Diabetes Endocrinol. 2020 Jul;8(7):570....
  • Sockalingam S, Leung SE, Cassin SE. The Impact of Coronavirus Disease 2019 on Bariatric Surgery: Redefining Psychosocial Care. Obesity...
  • Zhang X, Li X, Sun Z, He Y, Xu W, Campbell H, Dunlop MG, Timofeeva M, Theodoratou E. Physical activity and COVID-19:...
  • Zbinden-Foncea H, Francaux M, Deldicque L, Hawley JA. Does High Cardiorespiratory Fitness Confer Some Protection Against...
  • Rahmati-Ahmadabad S, Hosseini F. Exercise against SARS-CoV-2 (COVID-19): Does workout intensity matter? (A mini review of some indirect...
  • Altmann DM, Boyton RJ. SARS-CoV-2 T cell immunity: Specificity, function, durability, and role in protection. Sci Immunol. 2020 Jul...
  • Keech C, Albert G, Cho I, Robertson A, Reed P, Neal S, Plested JS, Zhu M, Cloney-Clark S, Zhou H, Smith G, Patel N, Frieman MB, Haupt RE,...
  • Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Pérez Marc G, Moreira ED, Zerbini C, Bailey R, Swanson...
  • Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, Diemert D, Spector SA, Rouphael N, Creech CB, McGettigan J, Kehtan...
  • Mozaffarian D, Rogoff KS, Ludwig DS. The real cost of food: can taxes and subsidies improve public health? JAMA. 2014 ...
  • Kanter R, Boza S. Strengthening Local Food Systems in Times of Concomitant Global Crises: Reflections From Chile. Am J Public Health....
  • Gillon-Keren M, Kaufman-Shriqui V, Goldsmith R, Safra C, Shai I, Fayman G, Berry E, Tirosh A, Dicker D, Froy O, Gordon...
  • Garden EM, Pallan M, Clarke J, Griffin T, Hurley K, Lancashire E, Sitch AJ, Passmore S, Adab P. Relationship between primary school healthy...