ReviewFrontiers in endocrinology2020
Hypercoagulopathy and Adipose Tissue Exacerbated Inflammation May Explain Higher Mortality in COVID-19 Patients With Obesity.
Review in Frontiers in endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 3 of them syntheses that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 3 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Hospital readmissions and post-discharge all-cause mortality in COVID-19 recovered patients; A systematic review and meta-analysis.The American journal of emergency medicine · 2022Pooled it
- Are fatty nuts a weighty concern? A systematic review and meta-analysis and dose-response meta-regression of prospective cohorts and randomized controlled trials.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2021Pooled it
- Visceral adiposity, subcutaneous adiposity, and severe coronavirus disease-2019 (COVID-19): Systematic review and meta-analysis.Clinical nutrition ESPEN · 2021Pooled it
- Dietary Changes and Anxiety during the Coronavirus Pandemic: Differences between the Sexes.Nutrients · 2021Trial
- Development and External Validation of a Prediction Model for Hypoxemia After Laparoscopic Sleeve Gastrectomy in Patients with Obesity: a Multicenter Retrospective Study.Obesity surgery · 2026Article
- The impact of diabetes and obesity on the severity and mortality of SARS-CoV-2 infection.Journal of diabetes and metabolic disorders · 2025Review
- Hidden Hunger in Pediatric Obesity: Redefining Malnutrition Through Macronutrient Quality and Micronutrient Deficiency.Nutrients · 2025Review
- Effect of obesity on the acute response to SARS-CoV-2 infection and development of post-acute sequelae of COVID-19 (PASC) in nonhuman primates.PLoS pathogens · 2025Article
- Immunomodulatory Mechanisms Underlying Neurological Manifestations in Long COVID: Implications for Immune-Mediated Neurodegeneration.International journal of molecular sciences · 2025Review
- The metabolic-immune interface of obesity in Covid-19: a role for angiotensin ii and inflammatory cytokines.Frontiers in immunology · 2025Article
- Tachykinins and the potential causal factors for post-COVID-19 condition.The Lancet. Microbe · 2023Review
- Obesity in Severe COVID-19 Patients Has a Distinct Innate Immune Phenotype.Biomedicines · 2023Article
- Obesity Is Associated with an Impaired Baseline Repertoire of Anti-Influenza Virus Antibodies.Microbiology spectrum · 2023Article
- Implications of obesity and adiposopathy on respiratory infections; focus on emerging challenges.World journal of clinical cases · 2023Review
- Evolution of SARS-CoV-2 Variants: Implications on Immune Escape, Vaccination, Therapeutic and Diagnostic Strategies.Viruses · 2023Review
- COVID-19 and liver injury in individuals with obesity.World journal of gastroenterology · 2023Review
- Do Body Mass Index and Nutritional Risk Score 2002 Influence the In-Hospital Mortality of Patients Following Cardiac Arrest?Nutrients · 2023Article
- COVID-19: Has the Liver Been Spared?International journal of molecular sciences · 2023Review
- SARS-CoV-2 and Influenza Vaccines in People with Excessive Body Mass-A Narrative Review.Life (Basel, Switzerland) · 2022Review
- Association between being underweight and excess body weight before SARS coronavirus type 2 infection and clinical outcomes of coronavirus disease 2019: Multicenter study.Nutrition (Burbank, Los Angeles County, Calif.) · 2022Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
COVID-19, caused by SARS-CoV-2, is characterized by pneumonia, lymphopenia, exhausted lymphocytes and a cytokine storm. Several reports from around the world have identified obesity and severe obesity as one of the strongest risk factors for COVID-19 hospitalization and mechanical ventilation. Moreover, countries with greater obesity prevalence have a higher morbidity and mortality risk of developing serious outcomes from COVID-19. The understanding of how this increased susceptibility of the people with obesity to develop severe forms of the SARS-CoV-2 infection occurs is crucial for implementing appropriate public health and therapeutic strategies to avoid COVID-19 severe symptoms and complications in people living with obesity. We hypothesize here that increased ACE2 expression in adipose tissue displayed by people with obesity may increase SARS-CoV-2 infection and accessibility to this tissue. Individuals with obesity have increased white adipose tissue, which may act as a reservoir for a more extensive viral spread with increased shedding, immune activation and pro-inflammatory cytokine amplification. Here we discuss how obesity is related to a pro-inflammatory and metabolic dysregulation, increased SARS-CoV-2 host cell entry in adipose tissue and induction of hypercoagulopathy, leading people with obesity to develop severe forms of COVID-19 and also death. Taken together, it may be crucial to better explore the role of visceral adipose tissue in the inflammatory response to SARS-CoV-2 infection and investigate the potential therapeutic effect of using specific target anti-inflammatories (canakinumab or anakinra for IL-1β inhibition; anti-IL-6 antibodies for IL-6 inhibition), anticoagulant or anti-diabetic drugs in COVID-19 treatment of people with obesity. Defining the immunopathological changes in COVID-19 patients with obesity can provide prominent targets for drug discovery and clinical management improvement.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.