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The
Coronavirus Attacks Fat Tissue, According to Scientists
The coronavirus seemed to target people
carrying extra pounds. Patients who were overweight or obese were
more likely to develop severe Covid-19 and more likely to die.
Though
these patients often have health conditions like diabetes that
compound their risk, scientists have become increasingly convinced
that their vulnerability has something to do with obesity itself.
Now
researchers have found that the coronavirus infects both fat cells
and certain immune cells within body fat, prompting a damaging
defensive response in the body.
“Indeed, the virus can infect fat cells
directly,’” said Dr. Philipp Scherer, a scientist who studies fat
cells at UT Southwestern Medical Center in Dallas, who was not
involved in the research.
“Whatever
happens in fat doesn’t stay in fat,” he added. “It affects the
neighboring tissues as well.”
The
research has not yet been peer-reviewed or published in a scientific
journal, but it was posted
online in
October. If the findings hold up, they may shed light not just on why
patients with excess pounds are vulnerable to the virus, but also on
why certain younger adults with no other risks become so ill.
The
finding is particularly relevant to the United States, which has one
of the highest rates of obesity in the world. Most American adults
are overweight, and 42 percent have obesity. Black, Hispanic, Native
American and Alaska Native people in the U.S. have higher obesity
rates than white adults and Asian Americans; they have also been
disproportionately affected by the pandemic, with death rates roughly
double those of white Americans.
“This
could well be contributing to severe disease,” Dr. Blish said.
“We’re seeing the same inflammatory cytokines that I see in the
blood of the really sick patients being produced in response to
infection of those tissues.”
Body
fat used to be thought of as inert, a form of storage. But scientists
now know that the tissue is biologically active, producing hormones
and immune-system proteins that act on other cells, promoting a state
of nagging low-grade inflammation even when there is no infection.
Inflammation
is the body’s response to an invader, and sometimes it can be so
vigorous that it is more harmful than the infection that triggered
it. “The more fat mass, and in particular visceral fat mass, the
worse your inflammatory response,” Dr. McLaughlin said, referring
to the abdominal fat that surrounds internal organs.
Fat
tissue is composed mostly of fat cells, or adipocytes. It also
contains pre-adipocytes, which mature into fat cells, and a variety
of immune cells, including a type called adipose tissue macrophages.
The
coronavirus appears to be able to evade the body fat’s immune
defenses, which are limited and incapable of fighting it effectively.
And in people who are obese, there can be a lot of body fat.
A
man whose ideal weight is 170 pounds but who weighs 250 pounds is
carrying a substantial amount of fat in which the virus may “hang
out,” replicate and trigger a destructive immune system response,
said Dr. David Kass, a professor of cardiology at Johns Hopkins.
“If
you really are very obese, fat is the biggest single organ in your
body,” Dr. Kass said.
The
data also suggest that Covid vaccines and treatments may need to take
into account the patient’s weight and fat stores.
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