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. 2020 Jun;57(6):759-764.
doi: 10.1007/s00592-020-01522-8. Epub 2020 Apr 5.

Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

Livio Luzi  1   2 , Maria Grazia Radaelli  3
Affiliations

Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

Livio Luzi et al. Acta Diabetol. 2020 Jun.

Abstract

Aims: Analyze the relationship between obesity and influenza.

Methods: Basal hormone milieu, defective response of both innate and adaptive immune system and sedentariness are major determinants in the severity of influenza viral infection in obese patients. Being overweight not only increases the risk of infection and of complications for the single obese person, but a large prevalence of obese individuals within the population might increase the chance of appearance of more virulent viral strain, prolongs the virus shedding throughout the total population and eventually might increase overall mortality rate of an influenza pandemic.

Results: Waiting for the development of a vaccination against COVID-19, isolation of positive cases and social distancing are the primary interventions. Nonetheless, evidence from previous influenza pandemics suggests the following interventions aimed at improving immune response: (1) lose weight with a mild caloric restriction; (2) include AMPK activators and PPAR gamma activators in the drug treatment for obesity associated with diabetes; and (3) practice mild-to-moderate physical exercise.

Conclusions: Due to prolonged viral shedding, quarantine in obese subjects should likely be longer than normal weight individuals.

Keywords: COVID-19; Immune-modulation; Influenza; Obese subjects.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The figure schematizes the bidirectional relationship between influenza/influenza-like viral infections and obesity. Adenovirus 36 was linked to the development of obesity. Obese condition is characterized by higher viral charge in breath and prolonged virus shedding. Life-style interventions and drugs commonly used to treat diabetes associated with obesity, cause a positive immune-modulation
See this image and copyright information in PMC

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