Summary: Apart from posing various mechanical and medical issues compromising general health, obesity is a major factor for respiratory tract infections, due to specific inflammation and immunological compromise. The burden of obesity on morbidity and mortality of SARS‐CoV‐2 infection/COVID‐19 is considerable. Herein, we aimed to search the literature and present to the readers pathophysiologic pathways that may associate obesity and COVID‐19. We present potential mechanisms, which might partly explain why patients with obesity are more prone to suffer from respiratory infections in the context of COVID‐19. Better understanding of these pathways could eventually guide management strategies and therapies for COVID‐19 in the future.

Background/Objectives: Athonian fasting, a rigorous form of intermittent fasting practiced by Christian Orthodox nuns and a subset of the Mediterranean diet, has known health benefits, but its impact on the interplay of adipokines, inflammatory cytokines, and vitamin D status remains under-investigated. This study aimed to elucidate these relationships within this controlled dietary context. Methods: This cross-sectional study examined the interplay of leptin, interleukin-6 (IL-6), and vitamin D in 41 overweight, vitamin D-sufficient Christian Orthodox nuns practicing Athonian fasting. Anthropometric, biochemical, and inflammatory markers were assessed in the nuns (mean age 53.4 ± 17.1 years, median monastery stay 17 years, median BMI 26.8 kg/m²). Results: Analysis revealed significant positive correlations between age and monastery stay (r = 0.615, p < 0.001), age and visceral fat (ρ = 0.791, p < 0.001), age and IL-6 (ρ = 0.647, p < 0.001), and BMI and IL-6 (ρ = 0.622, p < 0.001). Strong associations existed between adiposity (BMI, body fat, visceral fat), leptin, and IL-6. Specifically, body fat showed substantial positive correlations with visceral fat (ρ = 0.858, p < 0.001), leptin (ρ = 0.538, p < 0.001), and IL-6 (ρ = 0.675, p < 0.001). Visceral fat demonstrated strong positive correlations with leptin (ρ = 0.613, p < 0.001) and IL-6 (ρ = 0.741, p < 0.001). A significant positive correlation was also observed between leptin and IL-6 (ρ = 0.507, p = 0.003). Conversely, a significant negative correlation was found between 25(OH)D and PTH (ρ = −0.380, p = 0.016). Multivariate regression analysis did not reveal independent effects of leptin or IL-6 after adjusting for other factors. Conclusions: This study reveals a complex interplay of adiposity, inflammation, and vitamin D status in this unique population of Orthodox monastery fasters. The strong correlations suggest potential targets for interventions aimed at improving metabolic health. Future research should investigate the effects of vitamin D within the context of Athonian fasting.