INS and obesity due to melanocortin 4 receptor deficiency: Niederer et al.15attributed this finding to the baseline hypermetabolic state associated with obesity (resulting from a low‐grade chronic inflammatory state), which was not significantly affected by COVID‐19, though this does not explain the disparate findings with Karayiannis et al.14Patients with obesity differ from nonobese patients in their metabolic response to critical illness because of the effects of insulin resistance and relative inhibition of lipolysis, which can result in increased endogenous breakdown of lean body mass.20