Obesity Is a Risk Factor for Severe COVID-19 Infection

Associations with covid-19 hospitalisation amongst 406,793 adults: the UK Biobank prospective cohort study

“…Several mechanisms for obesity-mediated risk have been suggested, including higher propensity to thrombosis, poorer immune response or excess inflammatory response. 29 Obesity decreases key operating lung volumes and this effect appears particularly pronounced in men. 30 We observed a strong association with increased risk of severe covid-19 in ever smokers, indicating a harmful impact of smoking on the risk of developing severe covid-19.…”

The hypothalamus as a hub for SARS-CoV-2 brain infection and pathogenesis

“…However, despite emerging reports of the post-mortem detection of the virus in the cerebrospinal fluid (CSF) (see for example (4)) or brain parenchyma of patients (5), little is known about how and under what circumstances SARS-CoV-2 infects the brain.While the possibility of CNS infection has been largely underestimated due to the common view that angiotensin converting enzyme 2 (ACE2), the only confirmed cellular receptor for SARS-CoV-2 so far (6), is absent or expressed only at very low levels in the brain (7,8), and that too exclusively in vascular cells (He et al, bioRxiv 2020; doi: https://doi.org/10.1101.088500) the majority of these studies have focused on the cerebral cortex, ignoring the fact that other regions such as the hypothalamus, are rich in ACE2 (9). Intriguingly, most major risk factors for severe COVID-19 (male sex, age, obesity, hypertension, diabetes); reviewed by (10,11); could be mediated by normal or dysfunctional hypothalamic neural networks that regulate a variety of physiological processes: sexual differentiation and gonadal hormone production, energy homeostasis, fluid homeostasis/osmoregulation and even ageing (12)(13)(14). The hypothalamus is also directly linked to other parts of the CNS involved in functions affected in COVID-19 patients, including brainstem nuclei that control fluid homeostasis, cardiac function and respiration, as well as regions implicated in the perception or integration of odor and taste (12,(14)(15)(16)(17)(18).Here, we investigated the susceptibility of the hypothalamus and related brain regions to SARS-CoV-2 infection by analyzing the expression of ACE2 and the transmembrane proteinase, serine 2 (TMPRSS2), which cleaves the SARS-CoV-2 spike (S) protein, enabling it to be internalized, from existing data from the Allen Human Brain Atlas (AHBA) (19).…”

HMGB1: A Possible Crucial Therapeutic Target for COVID-19?

“…Patients with obesity are at an increased risk of developing COVID-19 [5,6], possibly aggravated further by the presence of nonalcoholic fatty liver disease [6]. Obe-sity is also characterized by low-grade chronic inflammation.…”