Obésité et COVID-19 : le choc fatal entre deux pandémies

SCHEEN, André

doi:10.1016/j.mmm.2020.05.009

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Obésité et COVID-19 : le choc fatal entre deux pandémies

SCHEEN, André

2020 • In Médecine des Maladies Métaboliques

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https://hdl.handle.net/2268/250433

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10.1016/j.mmm.2020.05.009

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Keywords :

Intensive care; ARDS COVID-19; Prognosis; Mortality; Mechanical ventilation

Abstract :

[fr] La pandémie actuelle de la maladie à coronavirus 2019 (COVID-19) se superpose à une autre pandémie bien connue dans notre société d'abondance, celle du surpoids et de l'obésité. L'obésité représente un risque accru d'infection COVID-19 sévère, amenant les patients en unité de soins intensifs (USI) pour une assistance respiratoire avec menace de décès. Les raisons en sont multiples : altération de la mécanique ventilatoire, présence de comorbidités comme le diabète, l'hypertension artérielle ou l'apnée obstructive du sommeil, enfin, des réactions immunologique et inflammatoire inappropriées et excessives, possiblement encore accentuées par des dépôts de graisse ectopique intrathoraciques. Ainsi, la COVID-19 pourrait remettre en cause le concept, appelé « obesity paradox », décrit dans les USI chez les patients avec détresse respiratoire aiguë. Par ailleurs, la présence d'une obésité fait en sorte que la COVID-19 sévère atteint des personnes plus jeunes que dans la population non obèse. Ces données imposent de renforcer les mesures préventives et curatives chez les patients obèses pour limiter le risque d'évolution défavorable en cas de COVID-19.
[en] The current pandemic caused by the coronavirus 2019 (COVID-19) is superimposed on another well-known pandemic in our society, that of overweight and obesity. Obesity represents a higher risk of severe COVID-19 infection, which may lead to the requirement of a mechanical ventilation in intensive care units (ICU) and premature death. The underlying mechanisms are multiple: alteration of the respiratory performance, presence of comorbidities such as diabetes, hypertension or obstructive sleep apnea, finally inadequate and excessive immunological responses, possibly aggravated by ectopic intrathoracic fat depots. Thus, COVID-19 may challenge the so-called "obesity paradox'' commonly reported in ICU among patients with acute respiratory distress syndrome. Furthermore, the presence of obesity increases the risk of worse outcome at a younger age. These findings require reinforced preventive and curative measures among obese patients to limit the risk of progression towards an unfavorable outcome in case of COVID-19.

Disciplines :

Endocrinology, metabolism & nutrition
Public health, health care sciences & services

Author, co-author :

SCHEEN, André ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de diabétologie, nutrition, maladies métaboliques

Language :

French

Title :

Obésité et COVID-19 : le choc fatal entre deux pandémies

Alternative titles :

[en] Obesity and COVID-19: The fatal shock between two pandemics

Publication date :

2020

Journal title :

Médecine des Maladies Métaboliques

ISSN :

1957-2557

eISSN :

2214-8477

Publisher :

Elsevier Masson, Paris, France

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 31 August 2020

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