The obesity paradox predicts the second wave of COVID-19 to be severe in western countries

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dc.contributor.authorKrams, Indrikis A.
dc.contributor.authorJõers, Priit
dc.contributor.authorLuoto, Severi
dc.contributor.authorTrakimas, Giedrius
dc.contributor.authorLietuvietis, Vilnis
dc.contributor.authorKrams, Ronalds
dc.contributor.authorKaminska, Irena
dc.contributor.authorRantala, Markus J.
dc.contributor.authorKrama, Tatjana
dc.contributor.institutionDepartment of Surgery
dc.date.accessioned2021-06-30T12:30:01Z
dc.date.available2021-06-30T12:30:01Z
dc.date.issued2021-01-25
dc.descriptionFunding Information: This work was funded by the Latvian Council of Science grants lzp-2018/1-0393 (I.A.K.), lzp-2018/2-0057 (T.K.), and lzp-2020/2-0271 (T.K.). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
dc.description.abstractWhile COVID-19 infection and mortality rates are soaring in Western countries, Southeast Asian countries have successfully avoided the second wave of the SARS-CoV-2 pandemic despite high population density. We provide a biochemical hypothesis for the connection between low COVID-19 incidence, mortality rates, and high visceral adiposity in Southeast Asian populations. The SARS-CoV-2 virus uses angiotensin-converting enzyme 2 (ACE2) as a gateway into the human body. Although the highest expression levels of ACE2 are found in people’s visceral adipose tissue in Southeast Asia, this does not necessarily make them vulnerable to COVID-19. Hypothetically, high levels of visceral adiposity cause systemic inflammation, thus decreasing the ACE2 amount on the surface of both visceral adipocytes and alveolar epithelial type 2 cells in the lungs. Extra weight gained during the pandemic is expected to increase visceral adipose tissue in Southeast Asians, further decreasing the ACE2 pool. In contrast, weight gain can increase local inflammation in fat depots in Western people, leading to worse COVID-related outcomes. Because of the biological mechanisms associated with fat accumulation, inflammation, and their differential expression in Southeast Asian and Western populations, the second wave of the pandemic may be more severe in Western countries, while Southeast Asians may benefit from their higher visceral fat depots.en
dc.description.statusPeer reviewed
dc.format.extent10
dc.format.extent1509758
dc.identifier.citationKrams, I A, Jõers, P, Luoto, S, Trakimas, G, Lietuvietis, V, Krams, R, Kaminska, I, Rantala, M J & Krama, T 2021, 'The obesity paradox predicts the second wave of COVID-19 to be severe in western countries', International Journal of Environmental Research and Public Health, vol. 18, no. 3, 1029. https://doi.org/10.3390/ijerph18031029
dc.identifier.doi10.3390/ijerph18031029
dc.identifier.issn1661-7827
dc.identifier.otherunpaywall: 10.3390/ijerph18031029
dc.identifier.otherMendeley: ed3a3339-c5b5-3462-b0ce-12979578852f
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/5750
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85099989534&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofInternational Journal of Environmental Research and Public Health
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectACE2
dc.subjectCOVID-19
dc.subjectQuarantine-15
dc.subjectSARS-CoV-2
dc.subjectSecond wave
dc.subjectSystemic inflammation
dc.subjectVisceral adipose tissue
dc.subjectWeight gain
dc.subject3.3 Health sciences
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectPollution
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectHealth, Toxicology and Mutagenesis
dc.subjectSDG 3 - Good Health and Well-being
dc.titleThe obesity paradox predicts the second wave of COVID-19 to be severe in western countriesen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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