docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2022-21-2-59-66docru-72Research ArticleЭНДОКРИНОЛОГИЯENDOCRINOLOGYОжирение и COVID-19: инсайты двух пандемийObesity and COVID-19: Insights from Two PandemicХалимовЮ. Ш.KhalimovYu. Sh.

Халимов Юрий Шавкатович — д. м. н. профессор, начальник кафедры военно-полевой терапии

194044, г. Санкт-Петербург

yushkha@gmail.comhttps://orcid.org/0000-0003-4934-320XАгафоновП. В.AgafonovP. V.

Агафонов Павел Владимирович — к. м. н., докторант при кафедре военно-полевой терапии

194044, г. Санкт-Петербург

agafonov23@yandex.ruКирееваЕ. Б.KireevaE. B.

Киреева Елена Борисовна — к. м. н., доцент кафедры военно-полевой терапии

194044, г. Санкт-Петербург

kirr72@mail.ruОрловЮ. В.OrlovYu. V.

Орлов Юрий Викторович — начальник отделения клиники военно-полевой терапии

194044, г. Санкт-Петербург

orlov21021975@mail.ruФГБВОУ ВО «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской ФедерацииРоссияS.M. Kirov Military Medical Academy (a Federal Government-funded Military Educational Institution of Higher Education)Russian Federation202215022025212ТЕРАПИЯ5966Copyright © Халимов Ю.Ш., Агафонов П.В., Киреева Е.Б., Орлов Ю.В., 20252025Халимов Ю.Ш., Агафонов П.В., Киреева Е.Б., Орлов Ю.В.Khalimov Y.S., Agafonov P.V., Kireeva E.B., Orlov Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/72Цель обзора

Цель обзора: представить патофизиологические механизмы развития коронавирусной инфекции у пациентов с ожирением, а также подходы к коррекции ожирения у данных больных по результатам анализа крупных рандомизированных клинических исследований кардиоваскулярной безопасности, представленных в базах данных PubMed, Cochrane Library, Google Scholar.

Основные положения

Основные положения. По результатам клинических исследований ожирение рассматривается как важнейший фактор риска развития множества коморбидных заболеваний, в том числе тяжелых форм и смертельных исходов новой коронавирусной инфекции. В основе более высокой частоты встречаемости и тяжести течения новой коронавирусной инфекции у пациентов с ожирением лежит комплекс факторов, главными из которых являются увеличение сердечно-сосудистого риска, в том числе склонность к тромбозам, снижение эффективности дыхательной системы, нарушение иммунного ответа, а также наличие хронического воспалительного состояния. Перечислены основные группы лекарственных препаратов, которые могут быть использованы для борьбы с липотоксичностью.

Заключение

Заключение. Доказано, что спектр позитивных эффектов новых антигипергликемических препаратов из групп агонистов глюкогоноподобного пептида 1 типа и ингибиторов натрий-глюкозного контранспортера 2 типа в сочетании с хорошо изученным профилем эффективности и безопасности представляет новую возможность для лечения ожирения в условиях пандемии коронавирусной инфекции.

Objective of the Review

Objective of the Review: To present the pathophysiological mechanisms of the coronavirus infection in obese patients, and approaches to obesity correction in this group of patients following an overview of large randomized clinical trials of cardiovascular safety from PubMed, Cochrane Library, Google Scholar.

Key Points

Key Points. Clinical trials have demonstrated that obesity is a significant risk factor of a number of comorbidities, including severe and fatal cases of the novel coronavirus infection. A higher prevalence and severity of the novel coronavirus infection in obese patients is caused by a set of factors, with the most significant factor being an increased cardiovascular risk, including tendency to blood-clotting, reduced respiratory efficiency, impaired immune response, and chronic inflammations. Main groups of medicinal products that can be used to manage lipotoxicity have been listed.

Conclusion

Conclusion. It has been proven that a range of positive effects from new antihyperglycemic agents (glucagon-like peptide-1 receptor agonists and sodium-glucose linked transporter-2 inhibitors), combined with a well-studied efficiency and safety profile, is a new method to manage obesity during the coronavirus pandemic.

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