Is adipose tissue a reservoir for viral spread, immune activation and cytokine amplification in COVID-19?

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Date
2020-04-21
Authors
Ryan, Paul MacDaragh
Caplice, Noel M.
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John Wiley & Sons, Inc.
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Abstract
Coronavirus disease 2019 (COVID-19), the worst pandemic in more than a century, has claimed >125,000 lives worldwide to date. Emerging predictors for poor outcome include advanced age, male gender, pre-existing cardiovascular disease and risk factors including hypertension, diabetes and more recently obesity. Herein, we posit new obesity-driven predictors of poor COVID-19 outcome, over and above the more obvious extant risks associated with obesity including cardiometabolic disease and hypoventilation syndrome in intensive care patients. We outline a theoretical mechanistic framework whereby adipose tissue in subjects with obesity may act as a reservoir for more extensive viral spread with increased shedding, immune activation and cytokine amplification. We propose studies to test this reservoir concept with a focus on specific cytokine pathways that might be amplified in subjects with obesity and COVID-19. Finally, we underscore emerging therapeutic strategies that might benefit subsets of patients in which cytokine amplification is excessive and potentially fatal.
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Keywords
Obesity , Poor COVID-19 outcome , Adipose tissue , Cytokine pathways , Cytokine amplification
Citation
Ryan, P. M. and Caplice, N. M. (2020) 'Is adipose tissue a reservoir for viral spread, immune activation and cytokine amplification in COVID-19?', Obesity. doi: 10.1002/oby.22843
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© 2020, the Obesity Society. Published by John Wiley & Sons, Inc. This is the peer reviewed version of the following article: Ryan, P. M. and Caplice, N. M. (2020) 'Is adipose tissue a reservoir for viral spread, immune activation and cytokine amplification in COVID-19?', Obesity, doi: 10.1002/oby.22843, which has been published in final form at https://doi.org/10.1002/oby.22843. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.