For infectious-disease outbreaks, clinical solutions typically focus on efficient pathogen destruction. However, the COVID-19 pandemic provides a reminder that infectious diseases are complex, multisystem conditions, and a holistic understanding will be necessary to maximize survival. For COVID-19 and all other infectious diseases, metabolic processes are intimately connected to the mechanisms of disease pathogenesis and the resulting pathology and pathophysiology, as well as the host defence response to the infection. Here, I examine the relationship between metabolism and COVID-19. I discuss why preexisting metabolic abnormalities, such as type 2 diabetes and hypertension, may be important risk factors for severe and critical cases of infection, highlighting parallels between the pathophysiology of these metabolic abnormalities and the disease course of COVID-19. I also discuss how metabolism at the cellular, tissue and organ levels might be harnessed to promote defence against the infection, with a focus on disease-tolerance mechanisms, and speculate on the long-term metabolic consequences for survivors of COVID-19.

对于传染病爆发，临床解决方案通常侧重于有效的病原体破坏。然而，COVID-19 大流行提醒人们，传染病是复杂的多系统疾病，需要全面了解才能最大限度地提高生存率。对于 COVID-19 和所有其他传染病，代谢过程与疾病发病机制和由此产生的病理学和病理生理学以及宿主对感染的防御反应密切相关。在这里，我研究了新陈代谢与 COVID-19 之间的关系。我讨论了为什么先前存在的代谢异常，例如 2 型糖尿病和高血压，可能是严重和危急感染病例的重要危险因素，强调这些代谢异常的病理生理学与 COVID-19 的病程之间的相似之处。我还讨论了如何利用细胞、组织和器官水平的新陈代谢来促进对感染的防御，重点关注疾病耐受机制，并推测 COVID-19 幸存者的长期代谢后果。