Obesity is strongly and independently associated with an increased risk of severe illness and death from coronavirus disease 2019 (COVID-19). The pathophysiological changes that result from elevated body weight lead to metabolic dysfunction, chronic inflammation, impaired immunological responses, and multisystem disorders, which increase vulnerability to severe illness from COVID-19. While vaccination strategies are under way across the world, the second and third waves of the pandemic, along with the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strains, continue to threaten the stability of medical systems worldwide. Furthermore, evidence from previous pandemics suggests that vaccines are less effective in obese individuals than in their healthy-weight counterparts over the long term. Therefore, a consideration of lifestyle changes that can boost metabolic health and immunity is critical to reduce the risk of complications and severe illness from viral infection. In this review, we discuss the potential mechanisms linking excess body weight with COVID-19 morbidity. We also present evidence that intermittent fasting (IF), a dietary program that has gained popularity in recent years, may be an effective strategy to improve metabolic health and immunity and thus reduce the impact of obesity on COVID-19 morbidity and mortality.

肥胖与 2019 年冠状病毒病 (COVID-19) 患重病和死亡的风险增加密切且独立相关。体重增加引起的病理生理变化会导致代谢功能障碍、慢性炎症、免疫反应受损和多系统疾病，从而增加患 COVID-19 重病的可能性。虽然全世界都在实施疫苗接种策略，但第二波和第三波大流行以及新型严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 毒株的出现，继续威胁着全球医疗系统的稳定。此外，以往大流行病的证据表明，从长远来看，疫苗对肥胖个体的效果不如对体重健康的个体有效。所以，考虑到可以促进新陈代谢健康和免疫力的生活方式改变对于降低病毒感染引起的并发症和严重疾病的风险至关重要。在这篇综述中，我们讨论了将超重与 COVID-19 发病率联系起来的潜在机制。我们还提供证据表明，间歇性禁食 (IF) 这一近年来流行的饮食计划可能是改善代谢健康和免疫力的有效策略，从而降低肥胖对 COVID-19 发病率和死亡率的影响。