tetano
Editor, Senior Moderator
Front Immunol
. 2026 Jan 5:16:1729494.
doi: 10.3389/fimmu.2025.1729494. eCollection 2025.
The metabolic-immune interface of obesity in Covid-19: a role for angiotensin ii and inflammatory cytokines
Cíntia Maria Rodrigues[SUP] 1 2 [/SUP], Juliane Duarte Santos[SUP] 3 [/SUP], Bruna Carolina Chaves Garcia[SUP] 3 [/SUP], Marcelo Henrique Fernandes Ottoni[SUP] 3 [/SUP], Karine Beatriz Costa[SUP] 3 [/SUP], Marina Luiza Baêta Costa[SUP] 3 [/SUP], Vívian Gonzalez Figueiredo[SUP] 3 [/SUP], Daniel Macedo[SUP] 3 [/SUP], Danilo Bretas de Oliveira[SUP] 3 4 [/SUP], Etel Rocha Vieira[SUP] 3 4 [/SUP], Evelin Capellari Cárnio[SUP] 1 [/SUP]
Affiliations
Background: Obesity is a major risk factor for severe COVID-19, partly explained by chronic systemic low-grade inflammation and renin-angiotensin-aldosterone system (RAAS) dysregulation.
Objectives: To investigate the relationship between obesity and COVID-19 severity by measuring plasma angiotensin II (Ang II) and pro and anti-inflammatory cytokines across BMI categories.
Methods: In a cross-sectional cohort of 142 adults (Lean and Obese), including mild and severe COVID-19 cases and matched uninfected controls. Plasma Ang II, IL-1β, IL-6, IL-10, and TNF were quantified by ELISA. Associations with BMI and clinical severity were assessed using ANOVA and correlation analyses.
Results: Obese patients showed elevated Ang II, IL-1β, IL-6, and TNF, alongside reduced IL-10, compared to lean individuals and controls. Ang II positively correlated with BMI. Severe cases showed elevated neutrophil-to-lymphocyte ratios and greater need for ventilatory support requirements. Notably, mortality occurred exclusively among obese patients.
Conclusion: Obesity exacerbates COVID-19 severity through RAAS imbalance and, amplified inflammatory responses. Ang II and pro-inflammatory cytokines may serve as early predictive biomarkers of disease progression in obese individuals, highlighting the metabolic-immune interface as a critical determinant of COVID-19 outcomes.
Keywords: RAAS; SARS - COV - 2; angiotensin II; cytokines; interleukins; obesity.
. 2026 Jan 5:16:1729494.
doi: 10.3389/fimmu.2025.1729494. eCollection 2025.
The metabolic-immune interface of obesity in Covid-19: a role for angiotensin ii and inflammatory cytokines
Cíntia Maria Rodrigues[SUP] 1 2 [/SUP], Juliane Duarte Santos[SUP] 3 [/SUP], Bruna Carolina Chaves Garcia[SUP] 3 [/SUP], Marcelo Henrique Fernandes Ottoni[SUP] 3 [/SUP], Karine Beatriz Costa[SUP] 3 [/SUP], Marina Luiza Baêta Costa[SUP] 3 [/SUP], Vívian Gonzalez Figueiredo[SUP] 3 [/SUP], Daniel Macedo[SUP] 3 [/SUP], Danilo Bretas de Oliveira[SUP] 3 4 [/SUP], Etel Rocha Vieira[SUP] 3 4 [/SUP], Evelin Capellari Cárnio[SUP] 1 [/SUP]
Affiliations
- PMID: 41562075
- PMCID: PMC12812578
- DOI: 10.3389/fimmu.2025.1729494
Background: Obesity is a major risk factor for severe COVID-19, partly explained by chronic systemic low-grade inflammation and renin-angiotensin-aldosterone system (RAAS) dysregulation.
Objectives: To investigate the relationship between obesity and COVID-19 severity by measuring plasma angiotensin II (Ang II) and pro and anti-inflammatory cytokines across BMI categories.
Methods: In a cross-sectional cohort of 142 adults (Lean and Obese), including mild and severe COVID-19 cases and matched uninfected controls. Plasma Ang II, IL-1β, IL-6, IL-10, and TNF were quantified by ELISA. Associations with BMI and clinical severity were assessed using ANOVA and correlation analyses.
Results: Obese patients showed elevated Ang II, IL-1β, IL-6, and TNF, alongside reduced IL-10, compared to lean individuals and controls. Ang II positively correlated with BMI. Severe cases showed elevated neutrophil-to-lymphocyte ratios and greater need for ventilatory support requirements. Notably, mortality occurred exclusively among obese patients.
Conclusion: Obesity exacerbates COVID-19 severity through RAAS imbalance and, amplified inflammatory responses. Ang II and pro-inflammatory cytokines may serve as early predictive biomarkers of disease progression in obese individuals, highlighting the metabolic-immune interface as a critical determinant of COVID-19 outcomes.
Keywords: RAAS; SARS - COV - 2; angiotensin II; cytokines; interleukins; obesity.