avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2021-11-3-209-216avk-1237Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESКоронавирусная инфекция у пациента с ожирением (обзор литературы)Coronavirus Infection an Obese Patient (Literature Review)https://orcid.org/0000-0002-7220-4745ПановаЕ. И.PanovaE. I.

Нижний Новгород 

Maria S. Pimankina 

Nizhny Novgorod

https://orcid.org/0000-0002-8280-2669ПиманкинаМ. С.PimankinaM. S.

Мария Сергеевна Пиманкина 

Нижний Новгород 

Nizhny Novgorod

marimed@yandex.ruКафедра эндокринологии и внутренних болезней ФГБОУ ВО «Приволжский исследовательский медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияDepartment of Endocrinology and Internal Diseases of Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of the Russian FederationRussian FederationГБУЗ НО «ГКБ № 13 Автозаводского района»; Кафедра эндокринологии и внутренних болезней ФГБОУ ВО «Приволжский исследовательский медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияState Budgetary Health Care Institution of the Nizhny Novgorod region «City clinical hospital № 13 Avtozavodsky district of the Nizhny Novgorod city; Department of Endocrinology and Internal Diseases of Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of the Russian FederationRussian Federation202130052021113209216Copyright © Панова Е.И., Пиманкина М.С., 20212021Панова Е.И., Пиманкина М.С.Panova E.I., Pimankina M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1237

В современном мире проблема ожирения на фоне пандемии новой коронавирусной инфекции приобрела особую опасность. С одной стороны, распространенность ожирения среди населения неуклонно растет, с другой — доказано, что лица с ожирением относятся к группе наиболее уязвимых в аспекте повышенного риска заражения и неблагоприятного прогноза. Это связано с наличием и особенностями развития различных патологических механизмов у данной категории больных. К ним относятся высокая экспрессия ангиотензинпревращающего фермента 2, высокая вероятность развития «цитокинового шторма», поддержание хронического воспалительного процесса в жировой ткани, изменение активности фермента дипептидилпептидазы-4, которые приводят к усугублению нарушения метаболизма в жировой ткани, а также нарушению иммунной протекции. Тяжесть состояния больных с ожирением, госпитализированных с COVID-19 (COronaVIrus Disease 2019), обусловлена наличием полиморбидности. Мировая врачебная практика в борьбе с пандемией COVID-19 показывает, что больные коронавирусной инфекцией на фоне ожирения чаще требуют госпитализации в отделения реанимации и интенсивной терапии и подключения к аппаратам искусственной вентиляции легких. В настоящее время продолжают изучаться особенности течения коронавирусной инфекции на фоне ожирения. К их числу относятся наличие тяжелой дыхательной недостаточности, высокий риск развития респираторного дистресссиндрома, тромбозов и тромбоэмболических осложнений, а также ухудшение течения хронических сердечно-сосудистых заболеваний, что приводит к развитию полиорганной недостаточности и смерти. Разработка лекарственных препаратов учитывает механизмы проникновения вируса в клетку, особенности его патофизиологии и взаимодействия с организмом человека.

In the modern world the problem of obesity in combination with new coronavirus infection has acquired a special danger. On the one hand, the prevalence of obesity among the population is steadily increasing, on the other-it has been proven that obese people are among the most vulnerable in terms of increased risk of infection and a serious prognosis. This is due to the presence and peculiarities of the development of various pathological mechanisms in this category of patients. These include: high expression of angiotensin-converting enzyme 2, a high probability of a «cytokine storm» developing, maintenance of a chronic inflammatory process in adipose tissue, changes in the activity of Dipeptidyl peptidase-4 enzyme. All these processes lead to an aggravation of metabolic disorders in adipose tissue and violation of immune protection. The world medical practice in the fight against the COVID-19 pandemic shows that patients with coronavirus infection against the background of obesity more often need hospitalization in intensive care units and connection to artificial ventilation equipment. Currently, many features of the course of coronavirus infection against the background of obesity have been identified and continue to be studied. These include: the presence of severe respiratory failure, a high risk of developing respiratory distress syndrome, thrombosis and thromboembolic complications, as well as worsening of the course of chronic cardiovascular diseases. All this eventually leads to the development of severe multiple organ failure, which is often the cause of death in this category of patients.

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