{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:53:46Z","timestamp":1788357226926,"version":"build-2803163510"},"reference-count":133,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Post-COVID-19 condition is recognized as a multifactorial disorder, with persistent presence of viral antigens, discordant immunity, delayed viral clearance, and chronic inflammation. Obesity has emerged as an independent risk factor for both SARS-CoV-2 infection and its subsequent sequelae. In this study, we aimed to predict the molecular mechanisms linking obesity and post-COVID-19 distress. Viral antigen-exposed adipose tissues display remarkable levels of viral receptors, facilitating viral entry, deposition, and chronic release of inflammatory mediators and cells in patients. Subsequently, obesity-associated inflammatory insults are predicted to disturb cellular and humoral immunity by triggering abnormal cell differentiation and lymphocyte exhaustion. In particular, the decline in SARS-CoV-2 antibody titers and T-cell exhaustion due to chronic inflammation may account for delayed virus clearance and persistent activation of inflammatory responses. Taken together, obesity-associated defective immunity is a critical control point of intervention against post-COVID-19 progression, particularly in subjects with chronic metabolic distress.<\/jats:p>","DOI":"10.3389\/fimmu.2024.1433531","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T04:44:53Z","timestamp":1723437893000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Obesity-compromised immunity in post-COVID-19 condition: a critical control point of chronicity"],"prefix":"10.3389","volume":"15","author":[{"given":"Soonwoo","family":"Jang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wooyoung","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuseok","family":"Moon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2021.01.016","article-title":"Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning","volume":"33","author":"Drucker","year":"2021","journal-title":"Cell Metab"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.15585\/mmwr.mm6943e3","article-title":"COVID-19\u2013associated hospitalizations among health care personnel\u2014COVID-NET, 13 states, March 1\u2013May 31, 2020","volume":"69","author":"Kambhampati","year":"2020","journal-title":"Morbidity Mortality Weekly Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1002\/oby.22808","article-title":"COVID 19 and the patient with obesity\u2013the editors speak out","volume":"28","author":"Ryan","year":"2020","journal-title":"Obes (Silver Spring Md)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e11","DOI":"10.1017\/S0950268820003027","article-title":"A meta-analysis of the association between obesity and COVID-19","volume":"149","author":"Yang","year":"2021","journal-title":"Epidemiol Infection"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/edm2.176","article-title":"The impact of obesity on severe disease and mortality in people with SARS-CoV-2: a systematic review and meta-analysis","volume":"4","author":"Seidu","year":"2021","journal-title":"Endocrinol Diabetes Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23096","article-title":"Visceral adiposity elevates the risk of critical condition in COVID-19: A systematic review and meta-analysis","volume":"29","author":"Foldi","year":"2021","journal-title":"Obes (Silver Spring)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-021-00907-1","article-title":"Body composition predictors of outcome in patients with COVID-19","volume":"45","author":"Bunnell","year":"2021","journal-title":"Int J Obes (Lond)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20220869","article-title":"Visceral to subcutaneous fat ratio predicts short-term mortality in patients with Covid 19","volume":"96","author":"Surov","year":"2023","journal-title":"A Multicenter Study Br J Radiol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01909-w","article-title":"Symptoms and risk factors for long COVID in non-hospitalized adults","volume":"28","author":"Subramanian","year":"2022","journal-title":"Nat Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"744457","DOI":"10.1016\/j.bjane.2023.08.001","article-title":"Chronic pain after hospital discharge on patients hospitalized for COVID-19: an observational study","volume":"74","author":"de Barros","year":"2023","journal-title":"Braz J Anesthesiol (English Ed)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.949351","article-title":"Body composition and cardiorespiratory fitness in overweight or obese people post COVID-19: A comparative study","volume":"13","author":"Lemos","year":"2022","journal-title":"Front Physiol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.26355\/eurrev_202309_33589","article-title":"post-COVID-19 condition in a cohort of hospitalized COVID-19 patients","volume":"27","author":"Bildirici","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1038\/s41467-022-29521-z","article-title":"Persistent COVID-19 symptoms in a community study of 606,434 people in England","volume":"13","author":"Whitaker","year":"2022","journal-title":"Nat Commun"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/oby.22843","article-title":"Is adipose tissue a reservoir for viral spread, immune activation, and cytokine amplification in coronavirus disease 2019","volume":"28","author":"Ryan","year":"2020","journal-title":"Obesity"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1005153","article-title":"Adipose tissue is a neglected viral reservoir and an inflammatory site during chronic HIV and SIV infection","volume":"11","author":"Damouche","year":"2015","journal-title":"PloS Pathog"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12977-016-0260-2","article-title":"Infectious SIV resides in adipose tissue and induces metabolic defects in chronically infected rhesus macaques","volume":"13","author":"Couturier","year":"2016","journal-title":"Retrovirology"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1010703","article-title":"Influenza A virus elicits peri-vascular adipose tissue inflammation and vascular dysfunction of the aorta in pregnant mice","volume":"18","author":"Oseghale","year":"2022","journal-title":"PloS Pathog"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-05542-y","article-title":"SARS-CoV-2 infection and persistence in the human body and brain at autopsy","volume":"612","author":"Stein","year":"2022","journal-title":"Nature"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(20)30115-4","article-title":"Histopathological findings and viral tropism in UK patients with severe fatal COVID-19: a post-mortem study","volume":"1","author":"Hanley","year":"2020","journal-title":"Lancet Microbe"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/s41422-021-00523-8","article-title":"A cohort autopsy study defines COVID-19 systemic pathogenesis","volume":"31","author":"Yao","year":"2021","journal-title":"Cell Res"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-022-01742-5","article-title":"Adipose tissue in COVID-19: detection of SARS-CoV-2 in adipocytes and activation of the interferon-alpha response","volume":"45","author":"Basolo","year":"2022","journal-title":"J Endocrinol Invest"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-022-06338-9","article-title":"Lingering SARS-coV-2 in gastric and gallbladder tissues of patients with previous COVID-19 infection undergoing bariatric surgery","volume":"33","author":"Hany","year":"2023","journal-title":"Obes Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cmet.2021.12.002","article-title":"Replication of SARS-CoV-2 in adipose tissue determines organ and systemic lipid metabolism in hamsters and humans","volume":"34","author":"Zickler","year":"2022","journal-title":"Cell Metab"},{"key":"B24","doi-asserted-by":"publisher","first-page":"5722","DOI":"10.1038\/s41467-022-33218-8","article-title":"SARS-CoV-2 infects adipose tissue in a fat depot-and viral lineage-dependent manner","volume":"13","author":"Saccon","year":"2022","journal-title":"Nat Commun"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.abm9151","article-title":"SARS-CoV-2 infection drives an inflammatory response in human adipose tissue through infection of adipocytes and macrophages","volume":"14","author":"Mart\u00ednez-Col\u00f3n","year":"2022","journal-title":"Sci Trans Med"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1038\/nature06902","article-title":"Dynamics of fat cell turnover in humans","volume":"453","author":"Spalding","year":"2008","journal-title":"Nature"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pbio.3001687","article-title":"Why does viral RNA sometimes persist after recovery from acute infections","volume":"20","author":"Griffin","year":"2022","journal-title":"PloS Biol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1126\/science.abc8665","article-title":"Structural basis for translational shutdown and immune evasion by the Nsp1 protein of SARS-CoV-2","volume":"369","author":"Thoms","year":"2020","journal-title":"Science"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.3390\/v15041026","article-title":"Lipid accumulation in host cells promotes SARS-CoV-2 replication","volume":"15","author":"Seitz","year":"2023","journal-title":"Viruses"},{"key":"B30","doi-asserted-by":"publisher","first-page":"10433","DOI":"10.1038\/s41598-020-67177-1","article-title":"Adipose tissue in health and disease through the lens of its building blocks","volume":"10","author":"Lenz","year":"2020","journal-title":"Sci Rep"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1530\/JOE-23-0027","article-title":"Do adipocytes serve as a reservoir for severe acute respiratory syndrome coronavirus-2","volume":"258","author":"Steenblock","year":"2023","journal-title":"J Endocrinol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmet.2021.09.009","article-title":"Hyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2","volume":"33","author":"Reiterer","year":"2021","journal-title":"Cell Metab"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000183883.72263.13","article-title":"A paracrine loop between adipocytes and macrophages aggravates inflammatory changes: role of free fatty acids and tumor necrosis factor \u03b1","volume":"25","author":"Suganami","year":"2005","journal-title":"Arteriosclerosis Thrombosis Vasc Biol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.molimm.2007.07.035","article-title":"Thrombocytes respond to lipopolysaccharide through Toll-like receptor-4, and MAP kinase and NF-\u03baB pathways leading to expression of interleukin-6 and cyclooxygenase-2 with production of prostaglandin E2","volume":"45","author":"Scott","year":"2008","journal-title":"Mol Immunol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M601284200","article-title":"Overexpression of monocyte chemoattractant protein-1 in adipose tissues causes macrophage recruitment and insulin resistance","volume":"281","author":"Kamei","year":"2006","journal-title":"J Biol Chem"},{"key":"B36","doi-asserted-by":"publisher","first-page":"115503","DOI":"10.1016\/j.ejmech.2023.115503","article-title":"Bench-to-bedside: Innovation of small molecule anti-SARS-CoV-2 drugs in China","author":"Yang","year":"2023","journal-title":"Eur J Medicinal Chem"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-020-00662-x","article-title":"Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues","volume":"9","author":"Li","year":"2020","journal-title":"Infect Dis Poverty"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.04.035","article-title":"SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues","volume":"181","author":"Ziegler","year":"2020","journal-title":"Cell"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1080\/21623945.2015.1131881","article-title":"ACE2\/Ang 1-7 axis: a critical regulator of epicardial adipose tissue inflammation and cardiac dysfunction in obesity","volume":"5","author":"Patel","year":"2016","journal-title":"Adipocyte"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1038\/nm1267","article-title":"A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus\u2013induced lung injury","volume":"11","author":"Kuba","year":"2005","journal-title":"Nat Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1126\/science.abb2507","article-title":"Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation","volume":"367","author":"Wrapp","year":"2020","journal-title":"Science"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1011168","article-title":"Human ACE2 expression, a major tropism determinant for SARS-CoV-2, is regulated by upstream and intragenic elements","volume":"19","author":"Snouwaert","year":"2023","journal-title":"PloS Pathog"},{"key":"B43","doi-asserted-by":"publisher","first-page":"3802","DOI":"10.1038\/s41467-021-24013-y","article-title":"Engineered ACE2 receptor therapy overcomes mutational escape of SARS-CoV-2","volume":"12","author":"Higuchi","year":"2021","journal-title":"Nat Commun"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e28805","DOI":"10.1002\/jmv.28805","article-title":"Nasal spray of an IgM-like ACE2 fusion protein HH-120 accelerates SARS-CoV-2 clearance: A single-center propensity score-matched cohort study","volume":"95","author":"Song","year":"2023","journal-title":"J Med Virol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"7975","DOI":"10.3390\/ijms22157975","article-title":"An overview of adipose tissue ACE2 modulation by diet and obesity. Potential implications in COVID-19 infection and severity","volume":"22","author":"Gomez-Zorita","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B46","doi-asserted-by":"publisher","first-page":"100283","DOI":"10.1016\/j.obmed.2020.100283","article-title":"Association of high level gene expression of ACE2 in adipose tissue with mortality of COVID-19 infection in obese patients","volume":"19","author":"Al-Benna","year":"2020","journal-title":"Obes Med"},{"key":"B47","doi-asserted-by":"publisher","first-page":"154440","DOI":"10.1016\/j.metabol.2020.154440","article-title":"Visceral fat is associated to the severity of COVID-19","volume":"115","author":"Favre","year":"2021","journal-title":"Metabolism"},{"key":"B48","doi-asserted-by":"publisher","first-page":"360","DOI":"10.14336\/AD.2021.0805","article-title":"ACE2 and COVID-19 susceptibility and severity","volume":"13","author":"Zheng","year":"2022","journal-title":"Aging Dis"},{"key":"B49","doi-asserted-by":"publisher","first-page":"4058","DOI":"10.1038\/s41598-022-07918-6","article-title":"ACE2 protein expression in lung tissues of severe COVID-19 infection","volume":"12","author":"Gheware","year":"2022","journal-title":"Sci Rep"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-023-00904-7","article-title":"The immunology of long COVID","volume":"23","author":"Altmann","year":"2023","journal-title":"Nat Rev Immunol"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(22)00127-8","article-title":"Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study","volume":"10","author":"Evans","year":"2022","journal-title":"Lancet Respir Med"},{"key":"B52","doi-asserted-by":"publisher","first-page":"e12997","DOI":"10.1111\/eci.12997","article-title":"Adipokine dysregulation and adipose tissue inflammation in human obesity","volume":"48","author":"Unamuno","year":"2018","journal-title":"Eur J Clin Invest"},{"key":"B53","doi-asserted-by":"publisher","first-page":"3806","DOI":"10.3390\/nu15173806","article-title":"Exploring the network between adipocytokines and inflammatory response in SARS-CoV-2 infection: a scoping review","volume":"15","author":"Nigro","year":"2023","journal-title":"Nutrients"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008687","article-title":"White blood cell counts in persons aged 65 years or more from the Cardiovascular Health Study: correlations with baseline clinical and demographic characteristics","volume":"143","author":"Bovill","year":"1996","journal-title":"Am J Epidemiol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009123","article-title":"Total and differential leukocyte counts as predictors of ischemic heart disease: the Caerphilly and Speedwell studies","volume":"145","author":"Sweetnam","year":"1997","journal-title":"Am J Epidemiol"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(03)00053-X","article-title":"Relationship of total and abdominal adiposity with CRP and IL-6 in women","volume":"13","author":"Rexrode","year":"2003","journal-title":"Ann Epidemiol"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0603","article-title":"Interleukin-6 regulates human adipose tissue lipid metabolism and leptin production","volume":"89","author":"Trujillo","year":"2004","journal-title":"Vitro J Clin Endocrinol Metab"},{"key":"B58","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1152\/physrev.1998.78.3.783","article-title":"Understanding adipocyte differentiation","volume":"78","author":"Gregoire","year":"1998","journal-title":"Physiol Rev"},{"key":"B59","doi-asserted-by":"publisher","first-page":"93","DOI":"10.7326\/0003-4819-152-2-201001190-00008","article-title":"Narrative review: the role of leptin in human physiology: emerging clinical applications","volume":"152","author":"Kelesidis","year":"2010","journal-title":"Ann Internal Med"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200603-312OC","article-title":"Leptin resistance protects mice from hyperoxia-induced acute lung injury","volume":"175","author":"Bellmeyer","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/j.biochi.2012.03.006","article-title":"Leptin, adiponectin and pulmonary diseases","volume":"94","author":"Assad","year":"2012","journal-title":"Biochimie"},{"key":"B62","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1038\/29795","article-title":"Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression","volume":"394","author":"Lord","year":"1998","journal-title":"Nature"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2021.12.003","article-title":"Leptin as a potential prognostic marker of the severity of COVID-19 infection in obese patients","volume":"32","author":"Baltodano-Calle","year":"2022","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"B64","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1002\/JLB.5HI1020-704R","article-title":"Leptin correlates with monocytes activation and severe condition in COVID-19 patients","volume":"110","author":"Wang","year":"2021","journal-title":"J Leukoc Biol"},{"key":"B65","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.cytogfr.2020.06.001","article-title":"SARS-CoV-2 infection: The role of cytokines in COVID-19 disease","volume":"54","author":"Costela-Ruiz","year":"2020","journal-title":"Cytokine Growth Factor Rev"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.922422","article-title":"Cytokine profiles associated with acute COVID-19 and long COVID-19 syndrome","volume":"12","author":"Queiroz","year":"2022","journal-title":"Front Cell Infection Microbiol"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.145.11.3796","article-title":"IL-4 directs the development of Th2-like helper effectors","volume":"145","author":"Swain","year":"1990","journal-title":"J Immunol (Baltimore Md: 1950)"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.170772","article-title":"Linking adipose tissue eosinophils, IL-4, and leptin in human obesity and insulin resistance","volume":"9","author":"Hernandez","year":"2024","journal-title":"JCI Insight"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1126\/sciimmunol.abl4509","article-title":"Adaptive immune determinants of viral clearance and protection in mouse models of SARS-CoV-2","volume":"6","author":"Israelow","year":"2021","journal-title":"Sci Immunol"},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1101\/2022.06.14.22276401","article-title":"Persistent circulating SARS-CoV-2 spike is associated with post-acute COVID-19 sequelae","author":"Swank","year":"2022","journal-title":"Medrxiv"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2017.131","article-title":"Increased risk of influenza among vaccinated adults who are obese","volume":"41","author":"Neidich","year":"2017","journal-title":"Int J Obes"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2011.208","article-title":"Obesity is associated with impaired immune response to influenza vaccination in humans","volume":"36","author":"Sheridan","year":"2012","journal-title":"Int J Obes"},{"key":"B73","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1038\/s41541-020-00266-4","article-title":"Reduced immune responses to hepatitis B primary vaccination in obese individuals with nonalcoholic fatty liver disease (NAFLD)","volume":"6","author":"Joshi","year":"2021","journal-title":"NPJ Vaccines"},{"key":"B74","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1056\/NEJM198605223142119","article-title":"Impaired immunogenicity of hepatitis B vaccine in obese persons","volume":"314","author":"Weber","year":"1986","journal-title":"New Engl J Med"},{"key":"B75","doi-asserted-by":"publisher","first-page":"e13078","DOI":"10.1111\/irv.13078","article-title":"Antibody responses to COVID-19 vaccination in people with obesity: A systematic review and meta-analysis","volume":"17","author":"Ou","year":"2023","journal-title":"Influenza Other Respir Viruses"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02343-2","article-title":"Accelerated waning of the humoral response to COVID-19 vaccines in obesity","volume":"29","author":"Van Der Klaauw","year":"2023","journal-title":"Nat Med"},{"key":"B77","doi-asserted-by":"publisher","first-page":"e28130","DOI":"10.1002\/jmv.28130","article-title":"A potential association between obesity and reduced effectiveness of COVID-19 vaccine-induced neutralizing humoral immunity","volume":"95","author":"Faizo","year":"2023","journal-title":"J Med Virol"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2456-9","article-title":"Convergent antibody responses to SARS-CoV-2 in convalescent individuals","volume":"584","author":"Robbiani","year":"2020","journal-title":"Nature"},{"key":"B79","doi-asserted-by":"publisher","first-page":"147","DOI":"10.3390\/vaccines9020147","article-title":"SARS-CoV-2 mRNA vaccines: immunological mechanism and beyond","volume":"9","author":"Bettini","year":"2021","journal-title":"Vaccines"},{"key":"B80","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41467-021-27797-1","article-title":"Immunoglobulin signature predicts risk of post-acute COVID-19 syndrome","volume":"13","author":"Cervia","year":"2022","journal-title":"Nat Commun"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.920627","article-title":"Immunologic phenotype of patients with long-COVID syndrome of 1-year duration","volume":"13","author":"Garc\u00eda-Abell\u00e1n","year":"2022","journal-title":"Front Immunol"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o988","article-title":"Are vaccines a potential treatment for long covid","author":"Sivan","year":"2022","journal-title":"Br Med J Publishing Group"},{"key":"B83","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-069676","article-title":"Trajectory of long covid symptoms after covid-19 vaccination: community based cohort study","volume":"377","author":"Ayoubkhani","year":"2022","journal-title":"bmj"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27689","article-title":"Relationship between changes in symptoms and antibody titers after a single vaccination in patients with Long COVID","volume":"94","author":"Tsuchida","year":"2022","journal-title":"J Med Virol"},{"key":"B85","doi-asserted-by":"publisher","first-page":"665","DOI":"10.21037\/atm","article-title":"Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA","volume":"9","author":"Zhou","year":"2021","journal-title":"Ann Trans Med"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267645","article-title":"Use of combined treatment of 3rd-generation cephalosporin, azithromycin and antiviral agents on moderate SARs-CoV-2 patients in South Korea: A retrospective cohort study","volume":"17","author":"Hong","year":"2022","journal-title":"PloS One"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.146.12.4055","article-title":"B cell response to fresh and effector T helper cells. Role of cognate TB interaction and the cytokines IL-2, IL-4, and IL-6","volume":"146","author":"Croft","year":"1991","journal-title":"J Immunol (Baltimore Md: 1950)"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.144.6.2031","article-title":"Heterogeneity of helper\/inducer T lymphocytes. IV. Stimulation of resting and activated B cells by Th1 and Th2 clones","volume":"144","author":"Abbas","year":"1990","journal-title":"J Immunol (Baltimore Md: 1950)"},{"key":"B89","doi-asserted-by":"publisher","DOI":"10.1084\/jem.167.4.1350","article-title":"Heterogeneity of helper\/inducer T lymphocytes. II. Effects of interleukin 4-and interleukin 2-producing T cell clones on resting B lymphocytes","volume":"167","author":"Boom","year":"1988","journal-title":"J Exp Med"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbamcr.2014.05.014","article-title":"Cytokines and chemokines: At the crossroads of cell signalling and inflammatory disease","volume":"1843","author":"Turner","year":"2014","journal-title":"Biochim Biophys Acta (BBA)-Molecular Cell Res"},{"key":"B91","first-page":"273","article-title":"Association of TGF-[beta] 1, IL-4 and IL-13 gene polymerphisms with asthma in a Chinese population","volume":"29","author":"Xue-Xi","year":"2011","journal-title":"Asian Pacific J Allergy Immunol"},{"key":"B92","doi-asserted-by":"publisher","DOI":"10.1084\/jem.167.1.183","article-title":"Differential regulation of IgG1 and IgE synthesis by interleukin 4","volume":"167","author":"Snapper","year":"1988","journal-title":"J Exp Med"},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.141.6.2050","article-title":"The effects of IL-4 and IL-5 on the IgA response by murine Peyer's patch B cell subpopulations","volume":"141","author":"Lebman","year":"1988","journal-title":"J Immunol"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.139.8.2669","article-title":"Interleukin 5 and interleukin 4 produced by Peyer's patch T cells selectively enhance immunoglobulin A expression","volume":"139","author":"Murray","year":"1987","journal-title":"J Immunol"},{"key":"B95","first-page":"7","article-title":"Leptin and the immune system: how nutritional status influences the immune response","volume":"11","author":"Matarese","year":"2000","journal-title":"Eur Cytokine Network"},{"key":"B96","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1997.4467","article-title":"T lymphopenia in genetically obese rats","volume":"86","author":"Tanaka","year":"1998","journal-title":"Clin Immunol Immunopathol"},{"key":"B97","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1096\/fsb2fasebj.12.1.57","article-title":"Leptin regulates proinflammatory immune responses","volume":"12","author":"Loffreda","year":"1998","journal-title":"FASEB J"},{"key":"B98","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.66.4.1800-1802.1998","article-title":"Increased leptin expression in mice with bacterial peritonitis is partially regulated by tumor necrosis factor alpha","volume":"66","author":"Moshyedi","year":"1998","journal-title":"Infection Immun"},{"key":"B99","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1111\/j.1651-2227.1980.tb07024.x","article-title":"Immunocompetence in obesity","volume":"69","author":"Chandra","year":"1980","journal-title":"Acta P\u00e6diatrica"},{"key":"B100","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(99)00077-2","article-title":"Influence of obesity on immune function","volume":"99","author":"Nieman","year":"1999","journal-title":"J Am Dietetic Assoc"},{"key":"B101","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1016\/j.it.2014.06.004","article-title":"T cell mediated immunity to influenza: mechanisms of viral control","volume":"35","author":"La Gruta","year":"2014","journal-title":"Trends Immunol"},{"key":"B102","doi-asserted-by":"crossref","DOI":"10.1096\/fj.12-221143","article-title":"Des-acyl ghrelin analogs prevent high-fat-diet-induced dysregulation of glucose homeostasis","volume":"27","author":"Delhanty","year":"2013","journal-title":"FASEB J"},{"key":"B103","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/6494795","article-title":"Role of T lymphocytes in type 2 diabetes and diabetes-associated inflammation","volume":"2017","author":"Xia","year":"2017","journal-title":"J Diabetes Res"},{"key":"B104","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.139793","article-title":"Obesity results in adipose tissue T cell exhaustion","volume":"6","author":"Porsche","year":"2021","journal-title":"JCI Insight"},{"key":"B105","doi-asserted-by":"publisher","DOI":"10.1016\/j.xcrm.2022.100663","article-title":"The IL-1\u03b2, IL-6, and TNF cytokine triad is associated with post-acute sequelae of COVID-19","volume":"3","author":"Schulthei\u00df","year":"2022","journal-title":"Cell Rep Med"},{"key":"B106","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1128\/mBio.01599-21","article-title":"Immunological profiling of COVID-19 patients with pulmonary sequelae","volume":"12","author":"Wu","year":"2021","journal-title":"MBio"},{"key":"B107","doi-asserted-by":"publisher","DOI":"10.1038\/s41590-021-01113-x","article-title":"Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection","volume":"23","author":"Phetsouphanh","year":"2022","journal-title":"Nat Immunol"},{"key":"B108","doi-asserted-by":"publisher","DOI":"10.1111\/all.14647","article-title":"Immunological imprint of COVID-19 on human peripheral blood leukocyte populations","volume":"76","author":"Kratzer","year":"2021","journal-title":"Allergy"},{"key":"B109","doi-asserted-by":"publisher","DOI":"10.1002\/eji.1830250554","article-title":"CD38 ligation induces discrete cytokine mRNA expression in human cultured lymphocytes","volume":"25","author":"Ausiello","year":"1995","journal-title":"Eur J Immunol"},{"key":"B110","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.886431","article-title":"Remodeling of T cell dynamics during long COVID is dependent on severity of SARS-CoV-2 infection","volume":"13","author":"Wiech","year":"2022","journal-title":"Front Immunol"},{"key":"B111","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-023-06651-y","article-title":"Distinguishing features of Long COVID identified through immune profiling","volume":"623","author":"Klein","year":"2023","journal-title":"Nature"},{"key":"B112","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00487","article-title":"The role of PD-1 in acute and chronic infection","volume":"11","author":"Jubel","year":"2020","journal-title":"Front Immunol"},{"key":"B113","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"jama"},{"key":"B114","doi-asserted-by":"publisher","first-page":"e13128","DOI":"10.1111\/obr.13128","article-title":"Individuals with obesity and COVID-19: a global perspective on the epidemiology and biological relationships","volume":"21","author":"Popkin","year":"2020","journal-title":"Obes Rev"},{"key":"B115","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2023.08.010","article-title":"Mechanisms and pathophysiology of SARS-CoV-2 infection of the adipose tissue","author":"Moser","year":"2023","journal-title":"Trends Endocrinol Metab"},{"key":"B116","doi-asserted-by":"publisher","DOI":"10.2337\/db06-1656","article-title":"Visceral fat adipokine secretion is associated with systemic inflammation in obese humans","volume":"56","author":"Fontana","year":"2007","journal-title":"Diabetes"},{"key":"B117","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-019-01052-3","article-title":"Sick fat: the good and the bad of old and new circulating markers of adipose tissue inflammation","volume":"42","author":"Barchetta","year":"2019","journal-title":"J Endocrinol Invest"},{"key":"B118","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2022.07.003","article-title":"The impact of body composition on mortality of COVID-19 hospitalized patients: A prospective study on abdominal fat, obesity paradox and sarcopenia","volume":"51","author":"Graziano","year":"2022","journal-title":"Clin Nutr ESPEN"},{"key":"B119","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2010.22","article-title":"The human visceral fat depot has a unique inflammatory profile","volume":"18","author":"Alvehus","year":"2010","journal-title":"Obesity"},{"key":"B120","doi-asserted-by":"publisher","DOI":"10.1111\/acel.13168","article-title":"Individual variation of the SARS-CoV-2 receptor ACE2 gene expression and regulation","volume":"19","author":"Chen","year":"2020","journal-title":"Aging Cell"},{"key":"B121","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.adk1599","article-title":"SARS-CoV-2 viral clearance and evolution varies by type and severity of immunodeficiency","volume":"16","author":"Li","year":"2024","journal-title":"Sci Trans Med"},{"key":"B122","doi-asserted-by":"publisher","DOI":"10.1080\/08916930600597326","article-title":"Reduced tetanus antibody titers in overweight children","volume":"39","author":"Eliakim","year":"2006","journal-title":"Autoimmunity"},{"key":"B123","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2023.104552","article-title":"Cellular and molecular biomarkers of long COVID: a scoping review","volume":"91","author":"Esp\u00edn","year":"2023","journal-title":"EBioMedicine"},{"key":"B124","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1002\/oby.23147","article-title":"Exercise and adipose tissue immunity: outrunning inflammation","volume":"29","author":"Winn","year":"2021","journal-title":"Obesity"},{"key":"B125","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(22)00159-X","article-title":"Long COVID: systemic inflammation and obesity as therapeutic targets","volume":"10","author":"Florencio","year":"2022","journal-title":"Lancet Respir Med"},{"key":"B126","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-022-00475-z","article-title":"From the ketogenic diet to the Mediterranean diet: the potential dietary therapy in patients with obesity after CoVID-19 infection (Post CoVID syndrome)","volume":"11","author":"Barrea","year":"2022","journal-title":"Curr Obes Rep"},{"key":"B127","doi-asserted-by":"publisher","first-page":"79","DOI":"10.3390\/vaccines10010079","article-title":"Rapid weight loss, central obesity improvement and blood glucose reduction are associated with a stronger adaptive immune response following COVID-19 mRNA vaccine","volume":"10","author":"Watanabe","year":"2022","journal-title":"Vaccines"},{"key":"B128","doi-asserted-by":"publisher","first-page":"2721","DOI":"10.3390\/nu11112721","article-title":"\u03b22 adrenergic regulation of the phagocytic and microbicide capacity of macrophages from obese and lean mice: Effects of exercise","volume":"11","author":"Mart\u00edn-Cordero","year":"2019","journal-title":"Nutrients"},{"key":"B129","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20402","article-title":"Acute exercise induces a phenotypic switch in adipose tissue macrophage polarization in diet-induced obese rats","volume":"21","author":"Oliveira","year":"2013","journal-title":"Obesity"},{"key":"B130","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00299-2","article-title":"Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial","volume":"23","author":"Bramante","year":"2023","journal-title":"Lancet Infect Dis"},{"key":"B131","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2021.109479","article-title":"Inhibitors of VPS34 and fatty-acid metabolism suppress SARS-CoV-2 replication","volume":"36","author":"Williams","year":"2021","journal-title":"Cell Rep"},{"key":"B132","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3026","article-title":"Management of post-acute covid-19 in primary care","volume":"370","author":"Greenhalgh","year":"2020","journal-title":"bmj"},{"key":"B133","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n136","article-title":"Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline","volume":"372","author":"Shah","year":"2021","journal-title":"bmj"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1433531\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T04:44:58Z","timestamp":1723437898000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1433531\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,12]]},"references-count":133,"alternative-id":["10.3389\/fimmu.2024.1433531"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1433531","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,12]]},"article-number":"1433531"}}