ArticleAmerican journal of reproductive immunology (New York, N.Y. : 1989)2020
Obesity as a contributor to immunopathology in pregnant and non-pregnant adults with COVID-19.
Article in American journal of reproductive immunology (New York, N.Y. : 1989), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Pooled it
- Maternal Obesity Modifies the Impact of Active SARS-CoV-2 Infection on Placental Pathology.Viruses · 2025Article
- Effects of WAKE.TAIWAN Healthy Lifestyle Web-Based Promotion Programs on Adults' Awareness of Self-perceived Weight Status and Their Healthy Lifestyle Stages: Retrospective Analysis.JMIR formative research · 2023Article
- The validity of self-reported SARS-CoV-2 results among postpartum respondents.Paediatric and perinatal epidemiology · 2022Article
- RAGE against the Machine: Can Increasing Our Understanding of RAGE Help Us to Battle SARS-CoV-2 Infection in Pregnancy?International journal of molecular sciences · 2022Review
- A temporal study of Brazilian pregnant and postpartum women vulnerability for COVID-19: Characteristics, risk factors and outcomes.Lancet regional health. Americas · 2022Article
- Maternal death due to COVID-19 and high BMI: A case report from Hamadan, Iran.Clinical case reports · 2022Article
- Impact of maternal nutrition in viral infections during pregnancy.Biochimica et biophysica acta. Molecular basis of disease · 2021Review
- Improving translational relevance: The need for combined exposure models for studying prenatal adversity.Brain, behavior, & immunity - health · 2021Article
- Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity.International journal of molecular sciences · 2021Review
- Case Report: SARS-CoV-2 Mother-to-Child Transmission and Fetal Death Associated With Severe Placental Thromboembolism.Frontiers in medicine · 2021Article
- Obesity as a contributor to immunopathology in pregnant and non-pregnant adults with COVID-19.American journal of reproductive immunology (New York, N.Y. : 1989) · 2020Article
- Special issue on COVID-19 and pregnancy: Consequences for maternal and neonatal health.American journal of reproductive immunology (New York, N.Y. : 1989) · 2020Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic has led to a global public health emergency with the need to identify vulnerable populations who may benefit from increased screening and healthcare resources. Initial data suggest that overall, pregnancy is not a significant risk factor for severe coronavirus disease 2019 (COVID-19). However, case series have suggested that maternal obesity is one of the most important comorbidities associated with more severe disease. In obese individuals, suppressors of cytokine signaling are upregulated and type I and III interferon responses are delayed and blunted leading to ineffective viral clearance. Obesity is also associated with changes in systemic immunity involving a wide range of immune cells and mechanisms that lead to low-grade chronic inflammation, which can compromise antiviral immunity. Macrophage activation in adipose tissue can produce low levels of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6). Further, adipocyte secretion of leptin is pro-inflammatory and high circulating levels of leptin have been associated with mortality in patients with acute respiratory distress syndrome. The synergistic effects of obesity-associated delays in immune control of COVID-19 with mechanical stress of increased adipose tissue may contribute to a greater risk of pulmonary compromise in obese pregnant women. In this review, we bring together data regarding obesity as a key co-morbidity for COVID-19 in pregnancy with known changes in the antiviral immune response associated with obesity. We also describe how the global burden of obesity among reproductive age women has serious public health implications for COVID-19.
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Registered trials
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