Obesity is a risk factor for SARS-CoV-2 infected patients to develop respiratory failure. Leptin produced in visceral fat might play a role in the deterioration to mechanical ventilation. A cross sectional study was performed. The mean BMI was 31 kg/m 2 (range 24.8–48.4) for the 31 SARS-CoV-2 ventilated patients and 26 kg/m 2 (range 22.4–33.5) for 8 critically ill non-infected control patients. SARS-CoV-2 infected patients with a similar BMI as control patients appear to have significantly higher levels of serum leptin. The mean leptin level was 21.2 (6.0–85.2) vs 5.6 (2.4–8.2) ug/L for SARS-CoV-2 and controls respectively (p = 0.0007). With these findings we describe a clinical and biological framework that may explain these clinical observations. The ACE2 utilization by the virus leads to local pulmonary inflammation due to ACE2-ATII disbalance. This might be enhanced by an increase in leptin production induced by SARS-CoV-2 infection of visceral fat. Leptin receptors in the lungs are now more activated to enhance local pulmonary inflammation. This adds to the pre-existent chronic inflammation in obese patients. Visceral fat, lung tissue and leptin production play an interconnecting role. This insight can lead the way to further research and treatment. Microbiology; Virology; Critical Care; Intensive Care Medicine; Respiratory System; SARS-CoV-2; COVID-19; fat; Leptin; ARDS; ACE2.
【저자키워드】 COVID-19, SARS-CoV-2, ACE2, ARDS, Microbiology, Virology, Critical care, Respiratory system, Leptin, Intensive care medicine, fat, 【초록키워드】 Treatment, Respiratory failure, mechanical ventilation, SARS-COV-2 infection, lung, Local, risk factor, virus, pulmonary inflammation, serum, Deterioration, Critically ill, Research, Control, chronic inflammation, cross, receptor, BMI, respiratory, clinical observations, control patients, obese patients, lung tissue, non-infected, ENhance, produced, develop, was performed, activated, increase in, significantly higher, explain, control patient, SARS-CoV-2 infected patient, ventilated patient, visceral, 【제목키워드】 cross-sectional, SARS-COV-2 infection, tissue, pathophysiological,