{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T16:22:45Z","timestamp":1780503765798,"version":"3.54.1"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005639","name":"Universidade de S\u00e3o Paulo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005639","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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-1\u03b2, IL-6, IL-10, and TNF were quantified by ELISA. Associations with BMI and clinical severity were assessed using ANOVA and correlation analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Obese patients showed elevated Ang II, IL-1\u03b2, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1729494","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:29:40Z","timestamp":1767590980000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The metabolic-immune interface of obesity in Covid-19: a role for angiotensin ii and inflammatory cytokines"],"prefix":"10.3389","volume":"16","author":[{"given":"C\u00edntia Maria","family":"Rodrigues","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane Duarte","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Carolina 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