key: cord-0817959-5j8otrzs authors: Guisado-Vasco, Pablo; Cano-Megías, Marta; Rodríguez-López, Margarita; de-Luna-Boquera, Iris Mercedes; Carnevali-Ruiz, Daniel title: COVID-19 and metabolic syndrome: NF-kB activation. Crossroads date: 2020-08-28 journal: Trends Endocrinol Metab DOI: 10.1016/j.tem.2020.08.004 sha: ba931ab1e2aae6fc1020d33c76ab81e5fe013451 doc_id: 817959 cord_uid: 5j8otrzs nan SARS-CoV2 was identified in December 2019 as the cause of severe pneumonia in a cluster of patients in Wuhan, China. Subsequently, this viral pathogen was described as a novel RNA betacoronavirus [1] . As other members of its group, SARS-CoV2 is able to cause a severe acute respiratory syndrome (named COVID-19 disease). Since the first clinical reports, age and presence of cardiovascular disease, diabetes mellitus and chronic lung disease, among other comorbidities, were identified as major risk factors of death among patients with COVID-19 [2-3] -including severe cases admitted to intensive care units [4] . It is also noteworthy that these comorbidities are constant in different countries. In fact, Garg et al [5] recently reported that almost 90% of hospitalized cases in the US had one or more of the following underlying conditions: hypertension, obesity, chronic lung disease, diabetes mellitus and cardiovascular disease. Emerging data suggest that diabetes mellitus and obesity (BMI > 30) are common risk factors in COVID-19 patients, with a high prevalence rate that reaches nearly 21% [3] and 40%, respectively [6] . However, the case-mortality rate varies in relation to individual countries and the epidemic impact of obesity in regional areas. Recent research underscores this concept, reporting that obesity and diabetes mellitus are special risk factors for the progression of severe COVID-19 inflammatory lung response (7) . On the other hand, most of the recently published studies do not report a high prevalence of severe COVID-19 in a priori more vulnerable patients, such as those affected with cancer, hematologic malignancies, solid organ transplant patients, or autoimmune diseasein fact, the prevalence of these patients in series were unexpectedly low (1%-8%, depending on the inclusion criteria). Besides, these studies have some limitations related to the multivariate subanalysis of comorbidities in this patients' group [2, 4] . Clinical characteristics of coronavirus disease 2019 in China Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV2 admitted to ICUs on the Lombardy Region Italy Hospitalization rates and characteristics of patients hospitalized with laboratoryconfirmed coronavirus disease 2019 -COVID-NET, 14 States Obesity in patients younger than 60 years is a risk factor for COVID-19 hospital admission Risk factors associated with acute respiratory syndrome and death in patients with coronavirus disease 2019 Wuhan, China 30 years of NF-kB: a blossoming of relevance of human pathobiology Inflammatory mechanisms linking obesity and metabolic disease The non-canonical NF-kB pathway and its contribution to B-cell failure in diabetes TLR4 links innate immunity and fatty acid-induced insulin resistance Nuclear factor-kappa B activation as a pathological mechanism of lipid metabolism and atherosclerosis NLRP3 inflammasome activation contributes to VSMC phenotypic transformation and proliferation in hypertension The SARS-coronavirus-host Interactome: identification of cyclophilins as target for pancoronavirus inhibitors Cyclophilins and cyclophilin inhibitors in Nidovirus replication