Obesity is already associated with decreased pulmonary function, and with the addition of COVID-19 injuring lung tissue, adequate ventilation would inevitably become more difficult.22 Biologically, obesity is also associated with higher levels of inflammatory cytokines, which may be exacerbated by the release of TNF-α and IL-6 from infected pneumocytes and pulmonary cells.23,24. This evidence concerns the gene TNF and obesity due to melanocortin 4 receptor deficiency.