Very early on clinicians around the world reported that in addition to aging and various heart pathologies, excess of body weight, especially obesity is a major risk factor for the severity of COVID-19 infection. The multitude of symptoms that have been described from human patients likely arises from the broad distribution of ACE2, a member of the angiotensin receptor family, the receptor for SARS-CoV-2, among which adipose tissue is a prominent one. We previously discussed some of the potential contributions of adipose tissue to the infection severity. While most of them have been supported by the recent literature novel hypothesis have also emerged, which will be discussed here. Moreover, recent pieces of evidence also support the notion that individuals with a high risk of severe disease are found at both extremes of the body mass index. Altogether these potential causes that lead to increased risk of severe forms of COVID-19 by deviation from standard BMI values open up for specific research and consideration of treatment of this population.

ACE2, Body mass index, COVID-19, Obesity, Lipid, SARS-CoV-2