Short-term complications and post-acute sequelae in hospitalized paediatric patients with COVID-19 and obesity: A multicenter cohort study

IF 2.7 3区医学 Q1 PEDIATRICS Pediatric Obesity Pub Date : 2022-10-12 DOI:10.1111/ijpo.12980

Gonzalo Valenzuela, Gonzalo Alarcón-Andrade, Clara Schulze-Schiapacasse, Rocío Rodríguez, Tamara García-Salum, Catalina Pardo-Roa, Jorge Levican, Eileen Serrano, María José Avenda?o, Monserrat Gutiérrez, Loreto Godoy, Pamela Céspedes, Sandra Bermudez, Javiera Aravena, Irini Nicolaides, Eliana Martínez, Constanza Gómez-Canobbio, Macarena Jofré, Andrea Salinas, Daniela Depaoli, Carolina Loza, Andrés Mu?oz, Natalia Ormazábal, Diana Manzur, José Barriga, Leonardo I. Almonacid, Estefany Poblete-Cárdenas, Erick Salinas, Andrés Mu?oz-Marcos, Salesa Barja, Rafael A. Medina

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引用次数: 4

Abstract

Background

Obesity increases the severity of coronavirus disease 2019 illness in adults. The role of obesity in short-term complications and post-acute sequelae in children is not well defined.

Objective

To evaluate the relationship between obesity and short-term complications and post-acute sequelae of SARS-CoV-2 infection in hospitalized paediatric patients.

Methods

An observational study was conducted in three tertiary hospitals, including paediatric hospitalized patients with a confirmatory SARS-CoV-2 RT-PCR from March 2020 to December 2021. Obesity was defined according to WHO 2006 (0–2 years) and CDC 2000 (2–20 years) growth references. Short-term outcomes were intensive care unit admission, ventilatory support, superinfections, acute kidney injury, and mortality. Neurological, respiratory, and cardiological symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms were considered as post-acute sequalae. Adjusted linear, logistic regression and generalized estimating equations models were performed.

Results

A total of 216 individuals were included, and 67 (31.02%) of them had obesity. Obesity was associated with intensive care unit admission (aOR = 5.63, CI95% 2.90–10.94), oxygen requirement (aOR = 2.77, CI95% 1.36–5.63), non-invasive ventilatory support (aOR = 6.81, CI95% 2.11–22.04), overall superinfections (aOR = 3.02 CI95% 1.45–6.31), and suspected bacterial pneumonia (aOR = 3.00 CI95% 1.44–6.23). For post-acute sequalae, obesity was associated with dyspnea (aOR = 9.91 CI95% 1.92–51.10) and muscle weakness (aOR = 20.04 CI95% 2.50–160.65).

Conclusions

In paediatric hospitalized patients with COVID-19, severe short-term outcomes and post-acute sequelae are associated with obesity. Recognizing obesity as a key comorbidity is essential to develop targeted strategies for prevention of COVID-19 complications in children.

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住院儿童COVID-19合并肥胖患者的短期并发症和急性后后遗症:一项多中心队列研究

肥胖会增加成人2019冠状病毒病的严重程度。肥胖在儿童短期并发症和急性后后遗症中的作用尚不明确。目的探讨肥胖症与住院儿童SARS-CoV-2感染短期并发症及急性后后遗症的关系。方法于2020年3月至2021年12月在三家三级医院进行观察性研究，包括确诊SARS-CoV-2 RT-PCR的儿科住院患者。肥胖的定义根据WHO 2006年(0-2岁)和CDC 2000年(2-20岁)的生长参考资料。短期结果为重症监护病房入院、呼吸支持、重复感染、急性肾损伤和死亡率。神经系统、呼吸系统和心脏病症状和/或症状出现后4周以上的延迟或长期并发症被认为是急性后后遗症。采用调整后的线性、逻辑回归和广义估计方程模型。结果共纳入216例，其中肥胖67例(31.02%)。肥胖与重症监护病房入院(aOR = 5.63, CI95% 2.90-10.94)、需氧量(aOR = 2.77, CI95% 1.36-5.63)、无创通气支持(aOR = 6.81, CI95% 2.11-22.04)、总体重复感染(aOR = 3.02 CI95% 1.45-6.31)和疑似细菌性肺炎(aOR = 3.00 CI95% 1.44-6.23)相关。对于急性后后遗症，肥胖与呼吸困难(aOR = 9.91 CI95% 1.92-51.10)和肌肉无力(aOR = 20.04 CI95% 2.50-160.65)相关。结论在COVID-19儿科住院患者中，严重的短期预后和急性后后遗症与肥胖相关。认识到肥胖是一种关键的合并症，对于制定预防儿童COVID-19并发症的有针对性战略至关重要。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.