ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12663ometendo-12663Research ArticleОбзор литературыReviewОсобенности течения и последствия COVID-19 у пациентов с избыточным весом и ожирением. Уроки текущей пандемииPeculiarities of the COVID-19 course and consequences in overweight and obese patients. Lessons from the current pandemichttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна, доктор медицинских наук, профессор

Москва

eLibrary SPIN: 9600-9796

Tatiana Yu. Demidova, MD, PhD, Professor

Moscow

eLibrary SPIN: 9600-9796

t.y.demidova@gmail.comhttps://orcid.org/0000-0003-3717-1148ВолковаЕ. И.VolkovaE. I.

Волкова Екатерина Игоревна, ординатор

Москва

Еkaterina I. Volkova, resident

Moscow

volkowa_endocrinology@mail.ruhttps://orcid.org/0000-0002-0086-869XГрицкевичЕ. Ю.GritskevichE. Yu.

Грицкевич Елена Юрьевна

109263, Москва, ул. Шкулева, д. 4, кор. 1

eLibrary SPIN: 4125-2055

Еlena Yu. Grickevich, MD

109263, Moscow, st. Shkuleva, 4/1

eLibrary SPIN: 4125-2055

genyan.7@mail.ruРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияN.I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian FederationRussian Federation202025122020174375384Copyright © Демидова Т.Ю., Волкова Е.И., Грицкевич Е.Ю., 20202020Демидова Т.Ю., Волкова Е.И., Грицкевич Е.Ю.Demidova T.Y., Volkova E.I., Gritskevich E.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12663

Трудности в лечении COVID-19 определили необходимость выявления прогностических факторов риска развития осложненного течения заболевания, критических состояний и смерти. Эндокринные и метаболические нарушения, связанные с ожирением, в том числе нарушение чувствительности к инсулину, хроническое воспаление и нарушение метаболизма липидов и жирных кислот, усиливают иммунологическую дисрегуляцию и делают подобных пациентов более подверженными развитию инфекционных заболеваний. Данные проведенных исследований позволяют выделить ожирение в качестве фактора риска отягощенного течения COVID-19, а также более длительного периода до элиминации вируса, а следовательно, опасности заражения окружающих. В обзоре представлены данные литературы об особенностях течения и механизмах развития осложнений у пациентов с новой коронавирусной инфекцией и  ожирением. Потенцирование сердечно-сосудистых факторов риска, увеличение продукции провоспалительных цитокинов, коагулопатии — факторы развития неблагоприятных исходов у таких пациентов. Обсуждены возможности терапии ожирения с помощью комбинированного препарата, содержащего в одной таблетке сибутрамин и метформин, с учетом необходимости восстановления метаболического здоровья для повышения адаптивных и резистентных возможностей организма в условиях угрозы нового роста распространенности COVID-19.

Treatment difficulties of COVID-19 have determined the need to identify predictive risk factors for the development of a complicated disease course, critical conditions and death. Endocrine and metabolic abnormalities associated with obesity, including impaired insulin sensitivity, chronic inflammation and impaired lipid and fatty acid metabolism, increase immunological dysregulation and make these patients more susceptible to developing infectious diseases. Research data allows us to single out obesity as a risk factor for the aggravated course of COVID-19, as well as a longer period before the virus elimination, and, therefore, the risk of virus transmission. Potentiation of cardiovascular risk factors, an increase in the production of pro-inflammatory cytokines, coagulopathy are factors in the development of unfavorable outcomes in such patients.This review presents literature data on the features of the course and the mechanisms of development of complications in patients with new coronavirus infection and obesity. Taking into account the need to restore metabolic health to increase the adaptive and resistant capacities of the body in the face of the threat of a new increase in the prevalence of COVID-19, the possibilities of treating obesity using a combined preparation containing sibutramine and metformin in one tablet, are discussed.

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The authors declare that there are no conflicts of interest present.