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World J Clin Cases. May 6, 2023; 11(13): 2925-2933
Published online May 6, 2023. doi: 10.12998/wjcc.v11.i13.2925
Implications of obesity and adiposopathy on respiratory infections; focus on emerging challenges
Ioannis G Lempesis, Vasiliki E Georgakopoulou
Ioannis G Lempesis, Vasiliki E Georgakopoulou, Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Athens 11527, Greece
Author contributions: Lempesis IG and Georgakopoulou VE designed research; Lempesis IG and Georgakopoulou VE performed research; Lempesis IG wrote the article; Georgakopoulou VE revised the article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vasiliki E Georgakopoulou, Doctor, MSc, Doctor, Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, 17 Agiou Thoma Street, Athens 11527, Greece. vaso_georgakopoulou@hotmail.com
Received: January 17, 2023
Peer-review started: January 17, 2023
First decision: February 17, 2023
Revised: February 17, 2023
Accepted: March 30, 2023
Article in press: March 30, 2023
Published online: May 6, 2023
Processing time: 97 Days and 12.1 Hours
Abstract

Obesity is characterized by excessive adipose tissue accumulation, which impacts physiological, metabolic, and immune functions. Several respiratory infections, including bacterial pneumonia, influenza, and coronavirus disease 2019, appear to be linked to unfavorable results in individuals with obesity. These may be attributed to the direct mechanical/physiological effects of excess body fat on the lungs’ function. Notably, adipose tissue dysfunction is associated with a low-grade chronic inflammatory status and hyperleptinemia, among other characteristics. These have all been linked to immune system dysfunction and weakened immune responses to these infections. A better understanding and clinical awareness of these risk factors are necessary for better disease outcomes.

Keywords: COVID-19; Influenza; Lung disease; Immune system; Obesity

Core Tip: Obesity influences the development and outcome of various respiratory infections. This is mediated in various ways, including through direct physiological impacts on the lungs and airways and via the dysfunctional adipose tissue, inducing a low-grade inflammatory status that potentially affects the immune response to certain pathogens. These include, notably, influenza and coronavirus disease 2019. Clinicians should be aware of these unique challenges in this subset of patients and take preventive and aggressive therapeutic measures as needed.