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      Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships

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          Summary

          The linkage of individuals with obesity and COVID‐19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID‐19, 75 studies were used to conduct a series of meta‐analyses on the relationship of individuals with obesity–COVID‐19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID‐19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID‐19 positive, >46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p < 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p < 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p < 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID‐19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID‐19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.

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          Most cited references200

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          SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor

          Summary The recent emergence of the novel, pathogenic SARS-coronavirus 2 (SARS-CoV-2) in China and its rapid national and international spread pose a global health emergency. Cell entry of coronaviruses depends on binding of the viral spike (S) proteins to cellular receptors and on S protein priming by host cell proteases. Unravelling which cellular factors are used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal therapeutic targets. Here, we demonstrate that SARS-CoV-2 uses the SARS-CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option. Finally, we show that the sera from convalescent SARS patients cross-neutralized SARS-2-S-driven entry. Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.
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            Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

            There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
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              Clinical and immunologic features in severe and moderate Coronavirus Disease 2019

              Journal of Clinical Investigation
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                Author and article information

                Contributors
                popkin@unc.edu
                Journal
                Obes Rev
                Obes Rev
                10.1111/(ISSN)1467-789X
                OBR
                Obesity Reviews
                John Wiley and Sons Inc. (Hoboken )
                1467-7881
                1467-789X
                26 August 2020
                : 10.1111/obr.13128
                Affiliations
                [ 1 ] Health, Nutrition and Population Global Practice The World Bank Washington, D.C. USA
                [ 2 ] Department of Nutrition, Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
                [ 3 ] Carolina Population Center University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
                [ 4 ] Saudi Health Council Riyadh Kingdom of Saudi Arabia
                [ 5 ] Community Health Sciences King Saud University Riyadh Kingdom of Saudi Arabia
                Author notes
                [*] [* ] Correspondence

                Barry M. Popkin, Nutrition Carolina Population Center, University of North Carolina at Chapel Hill, 123 W. Franklin St., Carolina Square, Chapel Hill, NC 27516‐3997, USA.

                Email: popkin@ 123456unc.edu

                Author information
                https://orcid.org/0000-0001-9495-9324
                Article
                OBR13128 OBR-06-20-4525.R1
                10.1111/obr.13128
                7461480
                32845580
                b5a7252d-d7c2-4199-aea4-3bf5b37d0dec
                © 2020 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 June 2020
                : 23 July 2020
                : 30 July 2020
                Page count
                Figures: 8, Tables: 1, Pages: 17, Words: 14208
                Funding
                Funded by: Bloomberg Philanthropies and the Carolina Population Center
                Award ID: CPC P2C HD050924
                Funded by: World Bank , open-funder-registry 10.13039/100004421;
                Funded by: Saudi Health Council
                Categories
                Covid‐19/Public Health
                Covid‐19/Public Health
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.8 mode:remove_FC converted:01.09.2020

                Medicine
                covid‐19,individuals with obesity,meta‐analysis,vaccination
                Medicine
                covid‐19, individuals with obesity, meta‐analysis, vaccination

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