Addressing Post-Acute COVID-19 Syndrome in Cancer Patients, from Visceral Obesity and Myosteatosis to Systemic Inflammation: Implications in Cardio-Onco-Metabolism
Vincenzo Quagliariello,
Maria Laura Canale,
Irma Bisceglia,
Carlo Maurea,
Domenico Gabrielli,
Luigi Tarantini,
Andrea Paccone,
Alessandro Inno,
Stefano Oliva,
Christian Cadeddu Dessalvi,
Concetta Zito,
Michele Caraglia,
Massimiliano Berretta,
Giuseppe D’Aiuto,
Nicola Maurea
Affiliations
Vincenzo Quagliariello
Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
Maria Laura Canale
U.O.C. Cardiologia, Ospedale Versilia, 55041 Lido di Camaiore, Italy
Irma Bisceglia
Servizi Cardiologici Integrati, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy
Carlo Maurea
Neurology Department, University of Salerno, 84084 Fisciano, Italy
Domenico Gabrielli
U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, Italy
Luigi Tarantini
Divisione di Cardiologia, Arcispedale S. Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio-Emilia, 42122 Reggio Emilia, Italy
Andrea Paccone
Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
Alessandro Inno
Medical Oncology, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
Stefano Oliva
UOSD Cardiologia di Interesse Oncologico IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy
Christian Cadeddu Dessalvi
Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy
Concetta Zito
Cardiology Division, University Hospital Polyclinic G. Martino, University of Messina, 98122 Messina, Italy
Michele Caraglia
Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via L. De Crecchio, 7, 80138 Naples, Italy
Massimiliano Berretta
Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
Giuseppe D’Aiuto
Clinica C.G. Ruesch, 80122 Naples, Italy
Nicola Maurea
Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Napoli, Italy
Cardiovascular disease and cancer are the two leading causes of morbidity and mortality in the world. The emerging field of cardio-oncology described several shared risk factors that predispose patients to both cardiovascular disease and cancer. Post-acute COVID-19 syndrome is a chronic condition that occurs in many patients who have experienced a SARS-CoV-2 infection, mainly based on chronic fatigue, sedentary lifestyle, cramps, breathing difficulties, and reduced lung performance. Post-acute COVID-19 exposes patients to increased visceral adiposity, insulin resistance, myosteatosis, and white adipose tissue content (surrounded by M1 macrophages and characterized by a Th1/Th17 phenotype), which increases the risk of cardiovascular mortality and cancer recurrence. In this review, the main metabolic affections of post-acute COVID-19 syndrome in cancer patients at low and high risk of cardiomyopathies will be summarized. Furthermore, several non-pharmacological strategies aimed at reducing atherosclerotic and cardiac risk will be provided, especially through anti-inflammatory nutrition with a low insulin and glycemic index, appropriate physical activity, and immune-modulating bioactivities able to reduce visceral obesity and myosteatosis, improving insulin-related signaling and myocardial metabolism.
