People with diabetes and obesity are at higher risk for severe respiratory illness caused by viruses, including serious complications from COVID-19. Diabetes and obesity are also linked to Long COVID, vaccine breakthrough infections and higher likelihood of other viral infections, like respiratory syncytial virus (RSV).
Research has found that COVID-19 can cause diabetes-related complications and insulin resistance, which greatly increases the risk of developing new-onset diabetes. Even though we know there is a connection between obesity, diabetes (known as metabolic diseases) and serious viral infections, the exact reason for this connection is not well understood.
Sergejs Berdnikovs, PhD, is an Associate Professor of Medicine (Allergy and Immunology) at the Northwestern University Feinberg School of Medicine. He is working to understand how metabolic diseases are linked to viral infections. With an American Lung Association Emerging Respiratory Pathogen Award, Dr. Berdnikovs is studying cells that line the airways called epithelial cells. These cells are important because they act as the first defense against viruses like SARS-CoV-2, the virus that causes COVID-19 when they enter the body. Dr. Berdnikovs is looking into why these cells from people with obesity and diabetes are more likely to get infected.
While it is known that there is a link between obesity, diabetes and COVID-19, it is not known what that means at the level of airway epithelial cells, Dr. Berdnikovs explained. “This is an important question because these cells are where the virus first comes into contact with the airways,” he said.
Before the pandemic, Dr. Berdnikovs was studying how viruses changed epithelial development by hijacking the cell’s metabolism. “When the pandemic hit, we found that COVID-19 was also exploiting the metabolism of epithelial cells,” he said. “I started to ask the questions I was asking before, but now in the context of COVID-19.”
Dr. Berdnikovs’ Lung Association funded research focuses on cells in airways sending signals to each other. He wants to learn how the virus affects or depends on the body’s energy processes, which help cells take in and process nutrients and produce energy. “We demonstrated that viral and energy pathways are codependent. But how? By understanding the mechanistic link between these two pathways, we can understand why a person with obesity who gets COVID-19 develops worse diabetes or develops new diabetes,” he said.
His research study has three parts. First, Dr. Berdnikovs will alter the metabolic pathways in epithelial cells, with or without viral infections to learn more about what makes these cells more likely to have severe COVID-19 infection.
Second, he will study samples from patients with diabetes, obesity and nondiabetic patients with COVID-19, to see how their genes are different. Finally, he will study how COVID-19 affects the lungs of obese mice to show the importance of metabolism in living organisms.
Dr. Berdnikovs hopes that this research will lead to better ways to protect people with diabetes and obesity from respiratory viruses. “This could take the form of different combinations of medicines tailored to address the additional health risks that people with metabolic diseases face during a pandemic,” he said.
The study will also provide important information about how diabetes and obesity impact lung health. “We need to understand why individuals who have obesity or diabetes are so susceptible to severe respiratory infection, so we can develop ways to protect them," he explained
Although this research focuses on COVID-19, Dr. Berdnikovs believes the findings could be useful for possible future respiratory pandemics. “Viruses need energy to replicate and survive. The body can’t shut down the metabolic pathways in response, because it also needs energy to survive,” he said. Because of this, this problem is very likely to happen again with future viruses. The findings will significantly advance our understanding of risk factors for COVID-19 infection and will improve preparedness for future pandemics.”
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Blog last updated: January 28, 2025
