ABSTRACT
Background: Obesity in children has reached epidemic proportions in the United States, and increased weight gain in school-aged children during summer months has been well documented. During the COVID-19 pandemic in the United States, there was concern that extended school closures would lead to increased obesity due to risk factors including more sedentary lifestyle and increased caloric intake. Obesity has multiple effects on asthma including on lung function and response to therapy. Significant weight gain in children with asthma during the pandemic could have sequelae beyond the known health effects of overweight and obesity in the general population. Methods: A retrospective chart review was performed of patients aged 6-18 years with asthma, seen in-person at a predominantly suburban pediatric pulmonology practice during four office visits from four time periods: January-April 2019 and July- October 2019 (pre-pandemic), January- April 2020 and July- October 2020 (pandemic). For each visit, data was collected on current height, weight, asthma medications, recent hospitalizations and exacerbations requiring systemic steroids. BMI and BMI percentile for age were calculated and patients were categorized by weight status based on Centers for Disease Control (CDC) definitions. Asthma severity was classified based on current therapies as per the Expert Panel Report-3 guidelines. Prevalence of overweight and obesity during each of the time periods was compared. Mean change in BMI between the two time periods in 2020 were compared to mean change in BMI between the two time periods in 2019. Results: 267 patients were included. Mean age was 10.0 + 2.5 years at the beginning of the study. 163 patients (61%) were male. 50.9% were overweight or obese during the pandemic compared to 46.8% in the previous year (p=0.34). Mean change in BMI was 0.81± 1.75 during the pandemic as compared to 0.5 ± 0.95 in the previous year (p = 0.01). Figure 1 demonstrates that BMI steadily increased for children in all weight categories for the first three time periods. Unlike normal weight children, BMI of overweight or obese children decreased during the last time period, i.e., the pandemic summer (2020). There were no differences in mean change in BMI during the pandemic compared to the year prior when stratified by sex, age group, type of insurance, asthma severity or prior CDC weight category. (Table 1). Conclusion: In this single-site retrospective study of children with asthma, there was a greater overall increase in BMI during the pandemic as compared to the previous year. However, children who were overweight or obese were more likely to lose weight during the pandemic. Reasons for this are unclear, but in this suburban community, may include increased participation in family outdoor activities and better nutrition with increased consumption of home-cooked foods in at-risk children.
ABSTRACT
The sudden onset of the coronavirus (SARS-CoV-2) pandemic has resulted in tremendous loss of human life and economy in more than 210 countries and territories around the world. While self-protections such as wearing masks, sheltering in place, and quarantine policies and strategies are necessary for containing virus transmission, tens of millions of people in the U.S. have lost their jobs due to the shutdown of businesses. Therefore, how to reopen the economy safely while the virus is still circulating in population has become a problem of significant concern and importance to elected leaders and business executives. In this study, mathematical modeling is employed to quantify the profit generation and the infection risk simultaneously from a business entity's perspective. Specifically, an ordinary differential equation model was developed to characterize disease transmission and infection risk. An algebraic equation is proposed to determine the net profit that a business entity can generate after reopening and take into account the costs associated of several protection/quarantine guidelines. All model parameters were calibrated based on various data and information sources. Sensitivity analyses and case studies were performed to illustrate the use of the model in practice. The results show that with a combination of necessary infection protection measures implemented, a business entity may stand a good opportunity to generate a positive net profit while successfully controlling the within-business infection prevalence under that in the general population. The use of personal protective equipment (PPE) is also found of significant importance, especially at the early stage of business reopening. © Copyright © 2020 Miao, Gao, Feng, Zhong, Zhu, Wu, Swartz, Luo, DeSantis, Lai, Bauer, Pérez, Rong and Lairson.