Accumulating evidence suggests that obesity is a major risk factor for the initiation, progression, and outcomes of coronavirus disease 2019 (COVID-19). The European Association for the Study of Obesity (EASO), as a scientific and medical society dedicated to the promotion of health and well-being, is greatly concerned about the concomitant obesity and COVID-19 pandemics and their impact on health and society at large. In this perspective, we will address the inherent immunological perturbations and alterations in the renin-angiotensin-aldosterone system in patients with obesity and COVID-19, and discuss how these impairments may underlie the increased susceptibility and more detrimental outcomes of COVID-19 in people with obesity. Clearly, this has important implications for preventive measures, vaccination, and future therapeutic strategies to combat COVID-19. Furthermore, we will highlight important knowledge gaps and provide suggestions for future research and recommendations for policy actions. Since many new reports on COVID-19 rapidly appear, the present perspective should be seen as a focus for discussion to drive forward further understanding, research initiatives, and clinical management of COVID-19.

Department of Endocrinology and Nutrition Clínica Universidad de Navarra University of Navarra IdiSNA CIBEROBN Spanish Health Institute Carlos 3 Pamplona Spain

Department of Human Biology NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre Maastricht The Netherlands

Department of Internal Medicine D and Obesity Clinic Hasharon Hospital Rabin Medical Center Petah Tikva Sackler School of Medicine Tel Aviv University Tel Aviv Israel

Department of Public Health and Preventive Medicine Faculty of Medicine in Pilsen Charles University Pilsen Czechia

European Association for the Study of Obesity Secretariat Teddington United Kingdom

European Association for the Study of Obesity Teddington United Kingdom

Obesity Prevention and Care Program Contrepoids Service of Endocrinology Diabetology Nutrition and Therapeutic Patient Education Department of Medicine Geneva University Hospitals and University of Geneva Geneva Switzerland

The Children's Obesity Clinic Department of Pediatrics Holbæk University Hospital Holbæk Denmark

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