Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third coronavirus leading to a global health outbreak. Despite the high mortality rates from SARS-CoV-1 and Middle-East respiratory syndrome (MERS)-CoV infections, which both sparked the interest of the scientific community, the underlying physiopathology of the SARS-CoV-2 infection, remains partially unclear. SARS-CoV-2 shares similar features with SARS-CoV-1, notably the use of the angiotensin conversion enzyme 2 (ACE2) as a receptor to enter the host cells. However, some features of the SARS-CoV-2 pandemic are unique. In this work, we focus on the association between obesity, metabolic syndrome, and type 2 diabetes on the one hand, and the severity of COVID-19 infection on the other, as it seems greater in these patients. We discuss how adipocyte dysfunction leads to a specific immune environment that predisposes obese patients to respiratory failure during COVID-19. We also hypothesize that an ACE2-cleaved protein, angiotensin 1-7, has a beneficial action on immune deregulation and that its low expression during the SARS-CoV-2 infection could explain the severity of infection. This introduces angiotensin 1-7 as a potential candidate of interest in therapeutic research on CoV infections.
【저자키워드】 Inflammation, ACE2, coronavirus, SARS-CoV, obesity, metabolic syndrome, adipocyte, 【초록키워드】 COVID-19, SARS-CoV-2, pandemic, Respiratory failure, Infection, SARS-CoV-1, immune, Protein, Health, infections, outbreak, severity of COVID-19, therapeutic, Research, CoV, Scientific community, receptor, patients, association, Angiotensin 1-7, host cells, dysfunction, acute respiratory syndrome, enzyme, low expression, syndrome, Severity of infection, high mortality rate, deregulation, feature, greater, unique, explain, obese patient, the SARS-CoV-2, type 2 diabete, 【제목키워드】 angiotensin, UMBRELLA, storm, Adipokine,