Bidirectionality between Cardiometabolic Diseases and COVID-19: Role of Humoral Immunity

Knutson, 2022 2022, Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21, Lancet, 399, 1513, 10.1016/S0140-6736(21)02796-3 Steenblock, 2021, COVID-19 and metabolic disease: mechanisms and clinical management, Lancet Diabetes Endocrinol, 9, 786, 10.1016/S2213-8587(21)00244-8 Stefan, 2022, Metabolic disorders, COVID-19 and vaccine-breakthrough infections, Nat. Rev. Endocrinol., 18, 75, 10.1038/s41574-021-00608-9 Stefan, 2021, Global pandemics interconnected — obesity, impaired metabolic health and COVID-19, Nat. Rev. Endocrinol., 17, 135, 10.1038/s41574-020-00462-1 Drucker, 2021, Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning, Cell Metab, 33, 479, 10.1016/j.cmet.2021.01.016 Barron, 2020, Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study, Lancet Diabetes Endocrinol, 8, 813, 10.1016/S2213-8587(20)30272-2 Perico, 2021, Immunity, endothelial injury and complement-induced coagulopathy in COVID-19, Nat. Rev. Nephrol., 17, 46, 10.1038/s41581-020-00357-4 O’Hearn, 2021, Coronavirus disease 2019 hospitalizations attributable to cardiometabolic conditions in the United States: a comparative risk assessment analysis, J. Am. Heart Assoc., 10 2021, Mapping the human genetic architecture of COVID-19, Nature, 600, 472, 10.1038/s41586-021-03767-x Qu, 2022, Mendelian randomization study of obesity and type 2 diabetes in hospitalized COVID-19 patients, Metabolism, 129, 10.1016/j.metabol.2022.155156 Freuer, 2021, Impact of body composition on COVID-19 susceptibility and severity: A two-sample multivariable Mendelian randomization study, Metabolism, 118, 10.1016/j.metabol.2021.154732 Cabrera-Mendoza, 2022, The association of obesity-related traits on COVID-19 severity and hospitalization is affected by socio-economic status: a multivariable Mendelian randomization study, Int. J. Epidemiol., 51, 1371, 10.1093/ije/dyac129 Yates, 2022, A population-based cohort study of obesity, ethnicity and COVID-19 mortality in 12.6 million adults in England, Nat. Commun., 13, 624, 10.1038/s41467-022-28248-1 Gao, 2021, Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study, Lancet Diabetes Endocrinol, 9, 350, 10.1016/S2213-8587(21)00089-9 Piernas, 2022, Associations of BMI with COVID-19 vaccine uptake, vaccine effectiveness, and risk of severe COVID-19 outcomes after vaccination in England: a population-based cohort study, Lancet Diabetes Endocrinol, 10, 571, 10.1016/S2213-8587(22)00158-9 Montefusco, 2021, Acute and long-term disruption of glycometabolic control after SARS-CoV-2 infection, Nat. Metab., 3, 774, 10.1038/s42255-021-00407-6 Rathmann, 2022, Incidence of newly diagnosed diabetes after Covid-19, Diabetologia, 65, 949, 10.1007/s00125-022-05670-0 Xie, 2022, Risks and burdens of incident diabetes in long COVID: a cohort study, Lancet Diabetes Endocrinol, 10, 311, 10.1016/S2213-8587(22)00044-4 Kelesidis, 2022, Cross-talk between SARS-CoV-2 infection and the insulin/IGF signaling pathway: implications for metabolic diseases in COVID-19 and for post-acute sequelae of SARS-CoV-2 infection, Metabolism, 134, 10.1016/j.metabol.2022.155267 Shin, 2022, SARS-CoV-2 infection impairs the insulin/IGF signaling pathway in the lung, liver, adipose tissue, and pancreatic cells via IRF1, Metabolism, 133, 10.1016/j.metabol.2022.155236 Hotamisligil, 2017, Inflammation, metaflammation and immunometabolic disorders, Nature, 542, 177, 10.1038/nature21363 Donath, 2019, Targeting innate immune mediators in type 1 and type 2 diabetes, Nat. Rev. Immunol., 19, 734, 10.1038/s41577-019-0213-9 Lackey, 2016, Regulation of metabolism by the innate immune system, Nat. Rev. Endocrinol., 12, 15, 10.1038/nrendo.2015.189 Laidlaw, 2022, The germinal centre B cell response to SARS-CoV-2, Nat. Rev. Immunol., 22, 7, 10.1038/s41577-021-00657-1 Sadarangani, 2021, Immunological mechanisms of vaccine-induced protection against COVID-19 in humans, Nat. Rev. Immunol., 21, 475, 10.1038/s41577-021-00578-z Kotaki, 2022, SARS-CoV-2 omicron-neutralizing memory B cells are elicited by two doses of BNT162b2 mRNA vaccine, Sci. Immunol., 7, 10.1126/sciimmunol.abn8590 Lutomski, 2021, Multiple roles of SARS-CoV-2 N protein facilitated by proteoform-specific interactions with RNA, host proteins, and convalescent antibodies, JACS Au, 1, 1147, 10.1021/jacsau.1c00139 Phetsouphanh, 2022, Immunological dysfunction persists for 8 months following initial mild-to-moderate SARS-CoV-2 infection, Nat. Immunol., 23, 210, 10.1038/s41590-021-01113-x Pape, 2021, High-affinity memory B cells induced by SARS-CoV-2 infection produce more plasmablasts and atypical memory B cells than those primed by mRNA vaccines, Cell Rep, 37, 10.1016/j.celrep.2021.109823 Scheja, 2019, The endocrine function of adipose tissues in health and cardiometabolic disease, Nat. Rev. Endocrinol., 15, 507, 10.1038/s41574-019-0230-6 Honecker, 2021, A distribution-centered approach for analyzing human adipocyte size estimates and their association with obesity-related traits and mitochondrial function, Int. J. Obes. (Lond)., 45, 2108, 10.1038/s41366-021-00883-6 Weisberg, 2003, Obesity is associated with macrophage accumulation in adipose tissue, J. Clin. Invest., 112, 1796, 10.1172/JCI200319246 Saltiel, 2017, Inflammatory mechanisms linking obesity and metabolic disease, J. Clin. Invest., 127, 1, 10.1172/JCI92035 Thomas, 2017, Macrophage functions in lean and obese adipose tissue, Metabolism, 72, 120, 10.1016/j.metabol.2017.04.005 Wong, 2022, Immune dysregulation and immunopathology induced by SARS-CoV-2 and related coronaviruses — are we our own worst enemy?, Nat. Rev. Immunol., 22, 47, 10.1038/s41577-021-00656-2 Bastard, 2020, Autoantibodies against type I IFNs in patients with life-threatening COVID-19, Science, 370, 10.1126/science.abd4585 Zhang, 2020, Inborn errors of type I IFN immunity in patients with life-threatening COVID-19, Science, 370, 10.1126/science.abd4570 Schoggins, 2019, Interferon-stimulated genes: what do they all do?, Annu. Rev. Virol., 6, 567, 10.1146/annurev-virology-092818-015756 Cromer, 2021, Prospects for durable immune control of SARS-CoV-2 and prevention of reinfection, Nat. Rev. Immunol., 21, 395, 10.1038/s41577-021-00550-x Kevadiya, 2021, Diagnostics for SARS-CoV-2 infections, Nat. Mater., 20, 593, 10.1038/s41563-020-00906-z Sah, 2021, Asymptomatic SARS-CoV-2 infection: a systematic review and meta-analysis, Proc. Natl. Acad. Sci. U. S. A., 118, 10.1073/pnas.2109229118 2021, COVID-19 vaccine breakthrough infections reported to CDC — United States, January 1–April 30, 2021, MMWR Mortal Wkly. Rep., 70, 792, 10.15585/mmwr.mm7021e3 Wendel, 2021, Transfusion, 61, 1447, 10.1111/trf.16323 Grzelak, 2021, Sex differences in the evolution of neutralizing antibodies to severe acute respiratory syndrome coronavirus 2, J. Infect. Dis., 224, 983, 10.1093/infdis/jiab127 De Giorgi, 2021, Anti-SARS-CoV-2 serology persistence over time in COVID-19 convalescent plasma donors, medRxiv Racine-Brzostek, 2021, Postconvalescent SARS-CoV-2 IgG and neutralizing antibodies are elevated in individuals with poor metabolic health, J. Clin. Endocrinol. Metab., 106, e2025, 10.1210/clinem/dgab004 Karuna, 2021, Neutralizing antibody responses over time in demographically and clinically diverse individuals recovered from SARS-CoV-2 infection in the United States and Peru: a cohort study, PLOS Med, 18, 10.1371/journal.pmed.1003868 Nilles, 2021, Epidemiological and immunological features of obesity and SARS-CoV-2, Viruses, 13, 2235, 10.3390/v13112235 Teresa Valenzuela, 2021, Development of neutralizing antibody responses against SARS-CoV-2 in COVID-19 patients, J. Med. Virol., 93, 4334, 10.1002/jmv.26939 Ko, 2020, Neutralizing antibody production in asymptomatic and mild COVID-19 patients, in comparison with pneumonic COVID-19 patients, J. Clin. Med., 9, 2268, 10.3390/jcm9072268 Sancilio, 2022, COVID-19 symptom severity predicts neutralizing antibody activity in a community-based serological study, Sci. Rep., 12, 10.1038/s41598-022-15791-6 Cromer, 2022, Neutralising antibody titres as predictors of protection against SARS-CoV-2 variants and the impact of boosting: a meta-analysis, Lancet Microbe, 3, e52, 10.1016/S2666-5247(21)00267-6 Shields, 2021, Serological responses to SARS-CoV-2 following non-hospitalised infection: clinical and ethnodemographic features associated with the magnitude of the antibody response, BMJ Open Respir. Res., 8, 10.1136/bmjresp-2020-000872 Gerhards, 2021, Longitudinal assessment of anti-SARS-CoV-2 antibody dynamics and clinical features following convalescence from a COVID-19 infection, Int. J. Infect. Dis., 107, 221, 10.1016/j.ijid.2021.04.080 De Greef, 2021, Determinants of IgG antibodies kinetics after severe and critical COVID-19, J. Med. Virol., 93, 5416, 10.1002/jmv.27059 Schmidt, 2021, Serological and viral genetic features of patients with COVID-19 in a selected German patient cohort-correlation with disease characteristics, Geroscience, 43, 2249, 10.1007/s11357-021-00443-w Epsi, 2021, Clinical, immunological, and virological SARS-CoV-2 phenotypes in obese and nonobese military health system beneficiaries, J. Infect. Dis., 224, 1462, 10.1093/infdis/jiab396 Li, 2021, Assessment of the association of vitamin D level with SARS-CoV-2 seropositivity among working-age adults, JAMA Netw. Open., 4, 10.1001/jamanetworkopen.2021.11634 Sami, 2021, Prevalence of SARS-CoV-2 antibodies in first responders and public safety personnel, New York City, New York, USA, May-July 2020, Emerg. Infect. Dis., 27, 796, 10.3201/eid2703.204340 Pathela, 2021, Seroprevalence of severe acute respiratory syndrome coronavirus 2 following the largest initial epidemic wave in the United States: findings from New York City, 13 May to 21 July 2020, J. Infect. Dis., 224, 196, 10.1093/infdis/jiab200 Kabagambe, 2022, Prevalence, distribution and IgG antibody levels associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among health-system and community-based employees and patients, Am. J. Med. Sci., 363, 18, 10.1016/j.amjms.2021.09.006 Lombardi, 2021, Seroprevalence of anti-SARS-CoV-2 IgG among healthcare workers of a large university hospital in Milan, Lombardy, Italy: a cross-sectional study, BMJ Open, 11, 10.1136/bmjopen-2020-047216 Jain, 2021, Characteristics of coronavirus disease 19 convalescent plasma donors and donations in the New York metropolitan area, Transfusion, 61, 2374, 10.1111/trf.16421 Krzywański, 2022, Elite athletes with COVID-19 - predictors of the course of disease, J. Sci. Med. Sport., 25, 9, 10.1016/j.jsams.2021.07.003 Kutsuna, 2021, Factors associated with anti-SARS-CoV-2 IgG antibody production in patients convalescing from COVID-19, J. Infect. Chemother., 27, 808, 10.1016/j.jiac.2021.01.006 Nah, 2021, Nationwide seroprevalence of antibodies to SARS-CoV-2 in asymptomatic population in South Korea: a cross-sectional study, BMJ Open, 11, 10.1136/bmjopen-2021-049837 Mahallawi, 2021, Assessment of SARS-CoV-2 anti-spike IgG antibody in women and children in Madinah, Saudi Arabia: a single-center study, Int. J. Environ. Res. Public Health., 18, 9971, 10.3390/ijerph18199971 Macedo-Ojeda, 2021, COVID-19 screening by anti-SARS-CoV-2 antibody seropositivity: clinical and epidemiological characteristics, comorbidities, and food intake quality, Int. J. Environ. Res. Public Health., 18, 8895, 10.3390/ijerph18178995 Mesenburg, 2021, Chronic non-communicable diseases and COVID-19: EPICOVID-19 Brazil results, Rev. Saude Publica., 55, 38, 10.11606/s1518-8787.2021055003673 Sharma, 2021, Second wave of the COVID-19 pandemic in Delhi, India: high seroprevalence not a deterrent?, Cureus, 13 De Santi, 2021, Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in an Italian cohort in Marche region, Italy, Acta Biomed., 92 Ding, 2021, Clinical value analysis of IgM and IgG antibodies detected by nucleic acid in patients with COVID-19, Am. J. Transl. Res., 13, 7089 Inbaraj, 2021, Seroprevalence of COVID-19 infection in a rural district of South India: a population-based seroepidemiological study, PLOS ONE, 16, 10.1371/journal.pone.0249247 Berenguer, 2021, Prevalence and factors associated with SARS-CoV-2 seropositivity in the Spanish HIV Research Network Cohort, Clin. Microbiol. Infect., 27, 1678, 10.1016/j.cmi.2021.06.023 Zejda, 2021, Seroprevalence of anti-SARS-CoV-2 antibodies in a random sample of inhabitants of the Katowice region, Poland, Int. J. Environ. Res. Public Health., 18, 3188, 10.3390/ijerph18063188 Schnittman, 2023, Effect of host factors and COVID-19 infection on the humoral immune repertoire in treated HIV, JCI Insight, 8, 10.1172/jci.insight.166848 Ahlqvist, 2020, Subtypes of type 2 diabetes determined from clinical parameters, Diabetes, 69, 2086, 10.2337/dbi20-0001 Sun, 2021, Plasticity and heterogeneity of thermogenic adipose tissue, Nat. Metab., 3, 751, 10.1038/s42255-021-00417-4 Dobaño, 2022, Sustained seropositivity up to 20.5 months after COVID-19, BMC Med, 20, 379, 10.1186/s12916-022-02570-3 Sabater Vidal, 2021, [Vaccine response to SARS-CoV-2 in hospital workers], Arch. Prev. Riesgos. Labor., 24, 383, 10.12961/aprl.2021.24.04.05 Beretta, 2021, Seroprevalence of the SARS-CoV-2 virus in the population of the southern Switzerland (Canton Ticino) - cohort study, results at 12 months, Swiss Med. Wkly., 151, 10.4414/SMW.2021.w30116 Levin, 2021, Waning immune humoral response to BNT162b2 Covid-19 vaccine over 6 months, N. Engl. J. Med., 385, e84, 10.1056/NEJMoa2114583 Malavazos, 2022, Antibody responses to BNT162b2 mRNA vaccine: infection-naïve individuals with abdominal obesity warrant attention, Obesity (Silver Spring), 30, 606, 10.1002/oby.23353 Lustig, 2021, BNT162b2 COVID-19 vaccine and correlates of humoral immune responses and dynamics: a prospective, single-centre, longitudinal cohort study in health-care workers, Lancet Respir. Med., 9, 999, 10.1016/S2213-2600(21)00220-4 Bayart, 2021, Confounding factors influencing the kinetics and magnitude of serological response following administration of BNT162b2, Microorganisms, 9, 1340, 10.3390/microorganisms9061340 Greco, 2021, Effects of influenza vaccination on the response to BNT162b2 messenger RNA COVID-19 vaccine in healthcare workers, J. Clin. Med. Res., 13, 549, 10.14740/jocmr4590 Gümüş, 2021, Side effects and antibody response of an inactive severe acute respiratory syndrome coronavirus 2 vaccine among health care workers, Rev. Assoc. Med. Bras., 67, 1825, 10.1590/1806-9282.20210755 Herzberg, 2022, SARS-CoV-2-antibody response in health care workers after vaccination or natural infection in a longitudinal observational study, Vaccine, 40, 206, 10.1016/j.vaccine.2021.11.081 Campo, 2021, Antibody persistence 6 months post-vaccination with BNT162b2 among health care workers, Vaccines (Basel)., 9, 1125, 10.3390/vaccines9101125 Pellini, 2021, Initial observations on age, gender, BMI and hypertension in antibody responses to SARS-CoV-2 BNT162b2 vaccine, EClinicalMedicine, 36, 10.1016/j.eclinm.2021.100928 Lee, 2021, Anti-SARS-CoV-2 spike protein RBD antibody levels after receiving a second dose of ChAdOx1 nCov-19 (AZD1222) vaccine in healthcare workers: lack of association with age, sex, obesity, and adverse reactions, Front. Immunol., 12, 10.3389/fimmu.2021.779212 Gaborit, 2023, Early humoral response to COVID-19 vaccination in patients living with obesity and diabetes in France. The COVPOP OBEDIAB study with results from the ANRS0001S COV-POPART cohort, Metabolism, 142, 10.1016/j.metabol.2023.155412 Mishra, 2021, Waning of anti-spike antibodies in AZD1222 (ChAdOx1) vaccinated healthcare providers: a prospective longitudinal study, Cureus, 13 Michos, 2021, Association of total and neutralizing SARS-CoV-2 spike -receptor binding domain antibodies with epidemiological and clinical characteristics after immunization with the 1st and 2nd doses of the BNT162b2 vaccine, Vaccine, 39, 5963, 10.1016/j.vaccine.2021.07.067 Pellini, 2021, Early onset of SARS-COV-2 antibodies after first dose of BNT162b2: correlation with age, gender and BMI, Vaccines (Basel)., 9, 685, 10.3390/vaccines9070685 Watanabe, 2022, Central obesity, smoking habit, and hypertension are associated with lower antibody titres in response to COVID-19 mRNA vaccine, Diabetes Metab. Res. Rev., 38, 10.1002/dmrr.3465 Özgür, 2022, [Antibody response after two doses of inactivated SARS-CoV-2 vaccine in healthcare workers with and without previous COVID-19 infection: a prospective observational study], Mikrobiyol. Bul., 56, 36, 10.5578/mb.20229904 Ben-Dov, 2022, Impact of tozinameran (BNT162b2) mRNA vaccine on kidney transplant and chronic dialysis patients: 3-5 months follow-up, J. Nephrol., 35, 153, 10.1007/s40620-021-01210-y Alqassieh, 2021, Pfizer-BioNTech and Sinopharm: a comparative study on post-vaccination antibody titers, Vaccines (Basel)., 9, 1223, 10.3390/vaccines9111223 Sourij, 2022, Humoral immune response to COVID-19 vaccination in diabetes is age-dependent but independent of type of diabetes and glycaemic control: the prospective COVAC-DM cohort study, Diabetes Obes. Metab., 24, 849, 10.1111/dom.14643 Cucchiari, 2021, Cellular and humoral response after MRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients, Am. J. Transplant., 21, 2727, 10.1111/ajt.16701 Karamese, 2022, The effectiveness of inactivated SARS-CoV-2 vaccine (CoronaVac) on antibody response in participants aged 65 years and older, J. Med. Virol., 94, 173, 10.1002/jmv.27289 Unsworth, 2020, New-onset type 1 diabetes in children during COVID-19: multicenter regional findings in the U.K, Diabetes Care, 43, e170, 10.2337/dc20-1551 Kamrath, 2020, Ketoacidosis in children and adolescents with newly diagnosed type 1 diabetes during the COVID-19 pandemic in Germany, JAMA, 324, 801, 10.1001/jama.2020.13445 Knip, 2023, SARS-CoV-2 and type 1 diabetes in children in Finland: an observational study, Lancet Diabetes Endocrinol, 11, 251, 10.1016/S2213-8587(23)00041-4 Jia, 2021, Prevalence of SARS-CoV-2 antibodies in children and adults with type 1 diabetes, Diabetes Technol. Ther., 23, 517, 10.1089/dia.2020.0609 Hippich, 2021, A public health antibody screening indicates a 6-fold higher SARS-CoV-2 exposure rate than reported cases in children, Med, 2, 149, 10.1016/j.medj.2020.10.003 Salmi, 2022, New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic, Arch. Dis. Child., 107, 180, 10.1136/archdischild-2020-321220 D’Addio, 2022, Immunogenicity and safety of SARS-CoV-2 mRNA vaccines in a cohort of patients with type 1 diabetes, Diabetes, 71, 1800, 10.2337/db22-0053 Atkinson, 2021, Distinguishing the real from the hyperglycaemia: does COVID-19 induce diabetes?, Lancet Diabetes Endocrinol, 9, 328, 10.1016/S2213-8587(21)00087-5 van der Heide, 2022, Limited extent and consequences of pancreatic SARS-CoV-2 infection, Cell Rep, 38, 10.1016/j.celrep.2022.110508 Kendall, 2022, Association of SARS-CoV-2 infection with new-onset type 1 diabetes among pediatric patients from 2020 to 2021, JAMA Netw. Open., 5, 10.1001/jamanetworkopen.2022.33014 Tao, 2021, The biological and clinical significance of emerging SARS-CoV-2 variants, Nat. Rev. Genet., 22, 757, 10.1038/s41576-021-00408-x Mistry, 2021, SARS-CoV-2 variants, vaccines, and host immunity, Front. Immunol., 12 Jones, 2021, Estimated US infection- and vaccine-induced SARS-CoV-2 seroprevalence based on blood donations, July 2020–May 2021, JAMA, 326, 1400, 10.1001/jama.2021.15161 Hong, 2021, Exposure density and neighborhood disparities in COVID-19 infection risk, Proc. Natl. Acad. Sci. U. S. A., 118, 10.1073/pnas.2021258118 Levy, 2022, Neighborhood socioeconomic inequality based on everyday mobility predicts COVID-19 infection in San Francisco, Seattle, and Wisconsin, Sci. Adv., 8, 10.1126/sciadv.abl3825 Schultz, 2018, Socioeconomic status and cardiovascular outcomes: challenges and interventions, Circulation, 137, 2166, 10.1161/CIRCULATIONAHA.117.029652 Zhu, 2022, WHO international standard for SARS-CoV-2 antibodies to determine markers of protection, Lancet Microbe, 3, e81, 10.1016/S2666-5247(21)00307-4 Dogan, 2021, SARS-CoV-2 specific antibody and neutralization assays reveal the wide range of the humoral immune response to virus, Commun. Biol., 4, 129, 10.1038/s42003-021-01649-6 Beaudoin-Bussières, 2022, A Fc-enhanced NTD-binding non-neutralizing antibody delays virus spread and synergizes with a nAb to protect mice from lethal SARS-CoV-2 infection, Cell Rep, 38, 10.1016/j.celrep.2022.110368 Castañé, 2022, Machine learning and semi-targeted lipidomics identify distinct serum lipid signatures in hospitalized COVID-19-positive and COVID-19-negative patients, Metabolism, 131, 10.1016/j.metabol.2022.155197 Nguyen, 2022, Preadmission use of antidiabetic medications and mortality among patients with COVID-19 having type 2 diabetes: a meta-analysis, Metabolism, 131, 10.1016/j.metabol.2022.155196 Boutari, 2022, A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on, Metabolism, 133, 10.1016/j.metabol.2022.155217 Amjadi, 2021, Specific COVID-19 symptoms correlate with high antibody levels against SARS-CoV-2, Immunohorizons, 5, 466, 10.4049/immunohorizons.2100022 Frasca, 2022, The majority of SARS-CoV-2-specific antibodies in COVID-19 patients with obesity are autoimmune and not neutralizing, Int. J. Obes. (Lond)., 46, 427, 10.1038/s41366-021-01016-9