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. 2023 Feb 7;10:1062491. doi: 10.3389/fcvm.2023.1062491

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Copyright © 2023 Xiang, Wu, Jing, Novakovic and Shi.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Pathophysiological changes of air-blood barrier in obese patients with COVID-19. (A) Adipose tissue has the potential to serve as a reservoir for SARS-CoV-2. (B) Immunocytes infiltrate adipose tissue, producing inflammatory mediators and adipokines, accompanied by a weakened specific immune response. (C) Under the combined effects of virus invasion, inflammation of adipocytes and lipid deposition, vascular endothelial destruction occurs prematurely, and the vascular wall structure is destroyed. The expression of protease activated receptor 1 (PAR-1), tissue factor (TF), P selectin, and phosphatidylserine (PS) on endothelial cells is up-regulated. (D) PS exposure on vascular endotheliocyte, erythrocyte, platelet, neutrophil, and lymphocyte appears earlier and participates in thrombosis. Adapted from “Adipocyte (white),” by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates.