LAUSR

Dear Editor, We have read with great interest the European Association for the Study of Obesity (EASO) Position Statement on the Global COVID-19 Pandemic, which emphasized the importance of evidence-based information and guidance to meet the healthcare needs of patients with obesity who have been affected by coronavirus disease 2019 (COVID-19). COVID-19 has affected more than 3.5 million people globally up to the present [1]. Although it did affect a great diversity of people all around the world, several accompanying diseases were highlighted for the majority of people who were hospitalized with the disease. In preliminary reports from China, the most common co-morbidities in patients who were infected with COVID-19 were type 2 diabetes, hypertension, chronic obstructive pulmonary disease, chronic renal disease, hepatitis B, coronary heart disease, cerebrovascular disease, and immunodeficiency [2]. Obesity was not mentioned as a common co-morbidity of COVID-19 infection, which was later attributed to the lower rates of obesity seen in far-east cultures. Similarly, obesity was not listed among clinical determinants for fatality, either. Age, gender, severity of illness, and co-morbidities such as hypertension, type 2 diabetes, cardiovascular disease, respiratory disease, and cancer were major factors distinguished between survivors and non-survivors of COVID-19 [3]. Then, body mass index (BMI) was the target of attention as severely ill patients were found to have a higher BMI than non-severely ill patients [4], and unfavorable outcomes were reported among COVID-19 patients with obesity [5, 6]. We know that visceral adiposity acts like an immune organ and causes low-grade chronic inflammation [7]. When it is combined with hyperinflammation and “cytokine storm” as seen in COVID-19, increased morbidity for people with obesity seems to be unavoidable [8]. Chronic inflammation can lead to persistent infections, and microbiota changes in obesity Received: May 13, 2020 Accepted: August 10, 2020 Published online: November 9, 2020