Obesity not only increases the risk of many noncommunicable diseases such as type 2 diabetes, cardiovascular diseases, different types of cancer and respiratory diseases, but also impacts communicable diseases.
Living with obesity puts people at greater risk of serious illness and death from COVID-19, with the risk of worse clinical outcomes growing substantially as body mass index (BMI) increases. EASO has recently discussed the relationship between obesity and COVID-19 with the World Health Organization, and emphasised the urgency of action to tackle the obesity and COVID-19 pandemics. Dr. Gijs Goossens from the Department of Human Biology (NUTRIM) at Maastricht University Medical Centre in The Netherlands, who also serves as co-chair of EASO’s Scientific Advisory Board, underscores that obesity prevention and continuous management of obesity and related complications are highly important during and after the COVID-19 pandemic.
Goossens explains that the renin-angiotensin system (RAAS), which is overactivated in obesity, increases blood pressure, and exerts proinflammatory and thrombogenic effects, amongst other detrimental effects that may contribute to organ damage. Furthermore, he points out that the increased fat mass in obesity, which is characterized by a pro-inflammatory phenotype and increased RAAS activity, might act as a reservoir for viral shedding and immune amplification, thereby impacting COVID-19 outcomes.
Currently, Gijs Goossens and his colleagues at Maastricht University Medical Centre are investigating the effects of blood pressure lowering medication that blocks the RAAS on the abundance of ACE2 (the entry receptor for SARS-CoV-2) in the adipose tissue of people with overweight. To examine this, study participants were treated with the RAAS blocker valsartan or placebo for 26 weeks, and adipose tissue biopsies were collected before after after treatment. Goossens and his team have previously shown that RAAS blockade reduced macrophage infiltration markers in human adipose tissue. To further explore the putative involvement of the RAAS in the development and progression of COVID-19, they now investigate the impact of RAAS blockade on ACE2 in human adipose tissue.