SARS-CoV-2 infects human adipose tissue and elicits an inflammatory response consistent with severe COVID-19

Abstract

The COVID-19 pandemic, caused by the viral pathogen SARS-CoV-2, has taken the lives of millions of individuals around the world. Obesity is associated with adverse COVID-19 outcomes, but the underlying mechanism is unknown. In this report, we demonstrate that human adipose tissue from multiple depots is permissive to SARS-CoV-2 infection and that infection elicits an inflammatory response, including the secretion of known inflammatory mediators of severe COVID-19. We identify two cellular targets of SARS-CoV-2 infection in adipose tissue: mature adipocytes and adipose tissue macrophages. Adipose tissue macrophage infection is largely restricted to a highly inflammatory subpopulation of macrophages, present at baseline, that is further activated in response to SARS-CoV-2 infection. Preadipocytes, while not infected, adopt a proinflammatory phenotype. We further demonstrate that SARS-CoV-2 RNA is detectable in adipocytes in COVID-19 autopsy cases and is associated with an inflammatory infiltrate. Collectively, our findings indicate that adipose tissue supports SARS-CoV-2 infection and pathogenic inflammation and may explain the link between obesity and severe COVID-19.

Post-acute sequelae of COVID-19: A metabolic perspective

“…Systemic viral persistence in PASC. There is emerging evidence that SARS-CoV-2 can infect and persist in adipose tissue and elsewhere ( Martínez-Colón et al, 2021 ; Reiterer et al, 2021 ). Li et al have published extensively on both viral persistence and viremia during COVID-19 ( Fajnzylber et al, 2020 ; Choi et al, 2020 ; Li et al, 2021 ).…”

Abdominal Imaging Associates Body Composition with COVID-19 Severity

“…Men are known to accumulate more visceral fat than women, who accumulate more subcutaneous fat [65]. With COVID-19 severity being higher in men, and also significantly associated with higher visceral fat (but not higher abdominal subcutaneous fat) in our study, it is possible that visceral fat is a main risk factor for disease severity, driven by the fact that the disease appears to be targeting adipose tissue cells [66,67]. We show that image-derived phenotypes are useful biomarkers for identifying at-risk subpopulations.…”

Understanding Kids and COVID

“…COVID-19 tends to be more severe for people carrying extra pounds. A preprint published in October found that the virus infects fat cells ( 14 ). So, overweight patients are “carrying around a bigger viral load with more fat cells for the virus to gain a hold in,” says Steinman.…”