Commentary: COVID-19 and obesity pandemics converge into a syndemic requiring urgent and multidisciplinary action

Abstract

While substantial evidence points towards obesity and associated cardiometabolic disorders being a major factor for poor outcomes in SARS-CoV2 infections (COVID-19), the complexity of the interplay between these two pandemics is becoming apparent. Indeed, as previously defined, this interaction between obesity and COVID-19 represents a 'syndemic' that requires both current and ongoing attention. At a mechanistic level the chronic inflammatory environment of obesity predisposes to life threatening events such as cytokine storm and enhanced coagulopathy. Obesity and its management are affected by diverse factors manifested at societal, educational, racial, and nutritional levels. A multidisciplinary approach is required to manage obese and type 2 diabetic patients, not only during the current COVID-19 crisis, but to decrease the growing burden of cardiometabolic disease and associated cardiovascular complications impacting future viral pandemics. Further, this syndemic has highlighted disparities in healthcare which need to be addressed to achieve equality in health outcomes in patients infected with COVID-19.

Fig. 1

Obesity is a contributor to poor outcomes in COVID-19. While obesity is a common factor in several comorbidities that have been implicated as risk factors for morbidity and mortality associated with COVID-19 infection, complex interactions exist not only at the cellular level but as relates to the multifactorial issues underlying fat distribution. This schematic has drawn on ideas presented in recent publications [35,38,67]. GIT – gastrointestinal tract; NAFLD – non alcohol fatty liver disease.