Endocrine Abstracts

The COVID-19 pandemic has forced the dispatch of significant efforts to identify prognostic factors development of critical conditions and death. Elderly age, cardiovascular disease (CVD), blood sugar diabetes, chronic lung disease, arterial hypertension was associated with an increased risk of death with COVID-19. Metabolic syndrome is a significant comorbid pathology, which increases the risk of developing life-threatening complications and unfavorable outcome of the coronavirus infection. Due to this patient with metabolic syndrome and COVID-19 deserve especially close attention. One of the main constituents of MS are abdominal obesity. Obesity potentiates multiple cardiovascular risk factors, underlying clinical cardiovascular continuum, leading to the development of CVD and adverse cardiovascular outcomes. This association between obesity and severe COVID-19 infection may be due to increased expression of ACE-2 in overweight individuals, making it more likely that SARS-CoV-2 enters the body of obese individuals compared to non-obese individuals. ACE-2 is present in lung alveolar epithelial cells, small intestine epithelial cells, vascular endothelial cells, and adipose tissue, and its expression is increased due to obesity. Increased expression of ACE-2 can cause greater penetration of SARS-CoV-2 into the body, which can significantly increase the release of cytokines and lead to a fatal outcome of COVID-19. Obese patients are more active nuclear transcription factor (NF) and higher RNA expression of proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1(IL-1) and interleukin-6 (IL-6), which are key in the pathogenesis of the metabolic syndrome [15]. Also, the pro-inflammatory role of IL-6 is often described in the pathogenesis of lung diseases, especially in asthma and in patients with acute respiratory distress syndrome (ARDS). Understanding the relationship between obesity and severe course of COVID-19 may suggest some therapeutic interventions to potentially reduce the risk of developing adverse outcomes of COVID-19. This issue becomes especially relevant weight gain and changes in food intake.