肥胖,炎症和COVID-19中的临床结果:一个多中心前性队列研究
Christina G Hutten1, Kishan Padalia2, Alexi Vasbinder1
1Division of Cardiology, Department of Internal Medicine, University of Michigan, Ann Arbor MI 48109, USA.
肥胖增加了COVID-19严重结果的风险,特别是在年轻人中,在Omicron变种出现之前. 炎症,特别是可溶性泌尿酶等离子激素激活受体 (suPAR),显著调解这种关联.
科学领域:
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 肥胖是已知的COVID-19患者严重结局的风险因素之一.
- 将肥胖与不良COVID-19结果联系在一起的确切机制仍然不完全理解.
- 据假设,炎症在调解这种关系方面起着至关重要的作用.
研究的目的:
- 调查炎症标志物是否调解肥胖和COVID-19结果之间的关联.
- 评估可溶性泌尿酸酶等离子体激活剂受体 (suPAR) 作为调解者的作用.
- 为了检查这种关联在不同的COVID-19变体 (前和后Omicron) 中是如何变化的.
主要方法:
- 未来的多中心观察研究 (国际COVID-19炎症研究 - ISIC).
- 包括住院COVID-19成年患者 (2020年2月 - 2022年10月).
- 在入院时测量炎症生物标志物 (包括suPAR) 和体重指数 (BMI);分析复合结果 (死亡,机械呼吸,置换疗法).
主要成果:
- 与非肥胖个体相比,BMI> 40的个体具有明显更高的不良综合结果的几率.
- 鉴定出溶性泌尿酸酶等离子体激活受体 (suPAR) 是BMI和复合结局之间的显著调解者.
- 肥胖和不良结果之间的关联在年轻的参与者 (<65岁) 和在Omicron变种前的时期中更为强烈.
结论:
- 肥胖与更糟糕的COVID-19结果显著相关,特别是在年轻人群中以及在Omicron变种之前.
- 通过suPAR水平量化的炎症,在肥胖和COVID-19不良结果之间的关系中起着关键的调解作用.
- 这些发现强调了在管理肥胖COVID-19患者时考虑炎症途径的重要性.
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