Obesidade e infecção por SARS-CoV-2: papel da metainflamação
DOI:
https://doi.org/10.34019/1982-8047.2020.v46.32241Palabras clave:
Obesidade, Pandemias, SARS-CoV-2, COVID-19Resumen
Introdução: O SARS-CoV-2, agente patológico da COVID-19, tem sido descrito como um vírus altamente infeccioso, transmitido de humano para humano com taxas de infecção alarmantes em todo o mundo. O elevado número de mortes devido à COVID-19 está em sua maioria associado à idade avançada ou à comorbidades. Dentre elas, citamos obesidade, diabetes mellitus, doenças cardiovasculares, doenças respiratórias crônicas, hipertensão arterial, coagulopatias e câncer. Objetivo: Esta revisão visa contribuir com uma atualização concisa e desenvolvimento do conhecimento científico além de trazer discussão sobre pontos ainda não muito bem compreendidos do impacto das alterações metabólicas e da ativação do sistema imunológico no desenvolvimento da COVID-19. Material e Métodos: Revisão de literatura de artigos científicos publicados entre 2002 e 2020, indexados nas bases de dados PubMed (National Library of Medicine and The National Institute of Health), Scielo (Scientific Eletronic Library Online), NCBI (National Center for Biotechnology Information) e Periódicos CAPES. Resultados e Discussão: A obesidade é caracterizada por um estado inflamatório de baixo grau, conhecido como inflamação metabólica ou metainflamação. Alterações decorrentes da inflamação metabólica, tornam o hospedeiro mais propenso a infecções e o sistema imunológico menos responsivo a vacinas, antivirais e antimicrobianos. Além disso, a obesidade e o SARS-CoV-2 compartilham elementos comuns da resposta imune e do processo inflamatório, como citocinas, quimiocinas e adipocinas secretados na metainflamação. Em adição, é possível que o vírus e a obesidade interajam em vias de sinalização comuns que amplificam distúrbios metabólicos, o que leva a exacerbação da infecção pelo SARS-CoV-2 em obesos. Conclusão: A resposta imunológica deficiente e comorbidades são importantes determinantes da gravidade da infecção viral por SARS-Cov-2 em pacientes obesos. Assim, sugere-se que a obesidade não apenas aumenta o risco de complicações da COVID-19 como também amplifica distúrbios imunometabólicos, o que pode levar à exacerbação da infecção pelo SARS-CoV-2 em indivíduos obesos.
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