Table 1.

Overview of mechanisms by which obesity contributes to worse prognosis of COVID-19.

Immune system	Chronic innate immune system activation
	Adaptive immune system dysregulation
	Lymphopenia
Endocrine and metabolic dysregulation in adipose tissue	Increased leptin secretion (pro-inflammatory)
	Decreased adiponectin secretion (anti-inflammatory)
	Hypoxia leading to low grade inflammation
Respiratory impairment	Reduced compliance, increased resistance
	Airway narrowing and collapse
	Reduced functional residual capacity
	Airway hyperresponsiveness
	Ventilation perfusion mismatch
Hemostasis	Enhanced prothrombotic state
Viral shedding	ACE2 expression on adipocytes
	Adipose tissue as potential reservoir for viruses
Comorbidities	Metabolic syndrome
	Type 2 Diabetes
	Cardiovascular disease, including hypertension
	Obstructive sleep apnea