The pandemic of COVID-19, caused by the coronavirus, SARS-CoV-2, has had a global impact not seen for an infectious disease for over a century. This acute pandemic has spread from the East and has been overlaid onto a slow pandemic of metabolic diseases of obesity and diabetes consequent from the increasing adoption of a Western-lifestyle characterized by excess calorie consumption with limited physical activity. It has become clear that these conditions predispose individuals to a more severe COVID-19 with increased morbidity and mortality. There are many features of diabetes and obesity that may accentuate the clinical response to SARS-CoV-2 infection: including an impaired immune response, an atherothrombotic state, accumulation of advanced glycation end products and a chronic inflammatory state. These could prime an exaggerated cytokine response to viral infection, predisposing to the cytokine storm that triggers progression to septic shock, acute respiratory distress syndrome, and multi-organ failure. Infection leads to an inflammatory response and tissue damage resulting in increased metabolic activity and an associated increase in the mechanisms by which cells ingest and degrade tissue debris and foreign materials. It is becoming clear that viruses have acquired an ability to exploit these mechanisms to invade cells and facilitate their own life-cycle. In obesity and diabetes these mechanisms are chronically activated due to the deteriorating metabolic state and this may provide an increased opportunity for a more profound and sustained viral infection.
【저자키워드】 SARS-CoV-2, obesity, diabetes, COVID−19, pandemic (COVID-19), 【초록키워드】 viral infection, coronavirus, immune response, pandemic, severe COVID-19, physical activity, Infectious disease, progression, Spread, metabolic disease, Septic shock, morbidity and mortality, mechanism, acute respiratory distress, Inflammatory response, cytokine response, inflammatory state, Trigger, clinical response, tissue, tissue damage, individual, syndrome, multi-organ failure, East, pandemic of COVID-19, feature, Cell, metabolic activity, resulting, caused, virus, facilitate, characterized, activated, condition, increase in, sustained, diabete, degrade, the cytokine storm, 【제목키워드】 spreading, East, consequence,