Obesity is associated with an increase in morbidity and mortality from Coronavirus disease- 2019 (COVID-19). Adipose tissue (AT) demonstrates high expression of angiotensin-converting enzyme 2 (ACE2), a host cell entry factor of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 has been shown to infect AT, where it continues to proliferate, thereby contributing to local inflammation. Since visceral AT inflammation may play a role in the pathogenesis of type 2 diabetes, we investigated the molecular and histological AT signatures after a Covid-19 infection and/or mRNA vaccination. We investigated 54 paired subcutaneous (SC) and visceral adipose tissue (VAT) biopsies from the Leipzig Obesity BioBank in subgroups based on positive versus negative SARS-CoV-2 infection as well as mRNA vaccination status in comparison to BMI and age matched controls obtained before appearance of Covid-19 (N=27). We compared gene expression signatures by RNA-Sequencing analyses, morphology changes in AT as well as circulating inflammation markers across the groups. In relation to a Covid-19 infection, we find a distinct gene expression signature and morphology in AT suggesting that SARS-CoV-2 affects AT and may mediate the disease course. In this context, inflammation of AT, but also an altered secretion profile from AT could link obesity to its metabolic complications, but also to long Covid-19 disease courses.


S.Krupka: None. M.Blüher: Advisory Panel; Boehringer Ingelheim Inc., Lilly, Novo Nordisk, Consultant; Novo Nordisk Foundation, Speaker's Bureau; Amgen Inc., AstraZeneca, Bayer Inc., Daiichi Sankyo, Novartis, Sanofi-Aventis Deutschland GmbH. N.Klöting: None.

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