The link between people with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search for Chinese and English literature on COVID 19, were used 75 studies to perform a series of meta-analysis on the relationship of individuals with obesity (COVID ? 19) across the spectrum from risk to mortality. A systematic review of mechanical pathways for COVID-19 and people with obesity is presented. Grouped analysis shows that people with obesity had an increased risk of COVID-19 positive,> 46,0% More (OR 1,46; IC of the 95%, 1,30-1,65; p <0,0001); for hospitalization, 113% More (OR 2,13; IC of the 95%, 1,74-2,60; p<0,0001); for UCI entry, 74% More (OR 1,74; IC of the 95%, 1,46-2,08); and for mortality, an increase in 48% in the deaths (OR 1,48; IC of the 95%, 1,22-1,80; p <0,001). Mechanistic pathways for people with obesity are presented in depth for factors related to coVID-19 risk, severity and their potential for decreased therapeutic and prophylactic treatments among these people. People with obesity are linked to significant large increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for people with obesity.