COVID-19 and metabolism: A look beyond the respiratory system and thrombotic disease

Abstract

COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that has important manifestations on the cardiovascular system and respiratory. This disease described in the first days of December 2019 in the city of Wuhan, capital of the province of Hubei, China, with a rapid global expansion and declared by the World Health Organization as a pandemic on March 11, 2020, has different clinical presentations such as pneumonia, hypoxemia, kidney failure, multisystem failure, endothelial involvement leading to venous and arterial thrombotic lesions, and heart problems such as heart failure, myocarditis, arrhythmias, and type 1 and 2 myocardial infarction. Most people have a mild or uncomplicated disease (80%), and others (20%) may develop a severe case with pneumonia, respiratory distress syndrome, cardiogenic shock, thrombosis, and cytokine storm (15% are managed with oxygen therapy and 5% merit treatment in the intensive care unit). Mortality is related to age and comorbidity (high blood pressure, diabetes mellitus, respiratory diseases, heart diseases in general, kidney diseases, and obesity). The objective of this narrative review is to describe the metabolic alterations and the relationship between diabetes mellitus, obesity, metabolic syndrome, and dyslipidemia with the morbidity and mortality associated with COVID-19 infection.