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The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19.
Tripathi, Sandeep; Christison, Amy L; Levy, Emily; McGravery, Jeremy; Tekin, Aysun; Bolliger, Dawn; Kumar, Vishakha K; Bansal, Vikas; Chiotos, Kathleen; Gist, Katja M; Dapul, Heda R; Bhalala, Utpal S; Gharpure, Varsha P; Heneghan, Julia A; Gupta, Neha; Bjornstad, Erica C; Montgomery, Vicki L; Walkey, Allan; Kashyap, Rahul; Arteaga, Grace M.
  • Tripathi S; Children's Hospital of Illinois, OSF Saint Francis Medical Center, Peoria, Illinois sandeept@uic.edu.
  • Christison AL; University of Illinois College of Medicine, Peoria, Illinois.
  • Levy E; Mayo Clinic, Rochester, Minnesota.
  • McGravery J; OSF HealthCare, Peoria, Illinois.
  • Tekin A; Mayo Clinic, Rochester, Minnesota.
  • Bolliger D; OSF HealthCare, Peoria, Illinois.
  • Kumar VK; Society of Critical Care Medicine, Mount Prospect, Illinois.
  • Bansal V; Mayo Clinic, Rochester, Minnesota.
  • Chiotos K; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Gist KM; University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado.
  • Dapul HR; Hassenfeld Children's Hospital at New York University Langone, New York City, New York.
  • Bhalala US; The Children's Hospital of San Antonio, Baylor College of Medicine; San Antonio, Texas.
  • Gharpure VP; Advocate Children's Hospital, Park Ridge, Illinois.
  • Heneghan JA; University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota.
  • Gupta N; University of Oklahoma College of Medicine, Oklahoma City, Oklahoma.
  • Bjornstad EC; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama.
  • Montgomery VL; University of Louisville and Norton Children's Hospital Louisville, Louisville, Kentucky.
  • Walkey A; The Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
  • Kashyap R; Mayo Clinic, Rochester, Minnesota.
Hosp Pediatr ; 11(11): e297-e316, 2021 11.
Article in English | MEDLINE | ID: covidwho-1282336
ABSTRACT

OBJECTIVE:

To describe the impact of obesity on disease severity and outcomes of coronavirus disease 2019 (COVID-19) among hospitalized children.

METHODS:

This retrospective cohort study from the Society of Critical Care Medicine Viral Respiratory Illness Universal Study registry included all children hospitalized with COVID-19 from March 2020 to January 2021. Obesity was defined by Centers for Disease Control and Prevention BMI or World Health Organization weight for length criteria. Critical illness definition was adapted from National Institutes of Health criteria of critical COVID. Multivariate mixed logistic and linear regression was performed to calculate the adjusted odds ratio of critical illness and the adjusted impact of obesity on hospital length of stay.

RESULTS:

Data from 795 patients (96.4% United States) from 45 sites were analyzed, including 251 (31.5%) with obesity and 544 (68.5%) without. A higher proportion of patients with obesity were adolescents, of Hispanic ethnicity, and had other comorbidities. Those with obesity were also more likely to be diagnosed with multisystem inflammatory syndrome in children (35.7% vs 28.1%, P = .04) and had higher ICU admission rates (57% vs 44%, P < .01) with more critical illness (30.3% vs 18.3%, P < .01). Obesity had more impact on acute COVID-19 severity than on multisystem inflammatory syndrome in children presentation. The adjusted odds ratio for critical illness with obesity was 3.11 (95% confidence interval 1.8-5.3). Patients with obesity had longer adjusted length of stay (exponentiated parameter estimate 1.3; 95% confidence interval 1.1-1.5) compared with patients without obesity but did not have increased mortality risk due to COVID-19 (2.4% vs 1.5%, P = .38).

CONCLUSION:

In a large, multicenter cohort, a high proportion of hospitalized children from COVID-19 had obesity as comorbidity. Furthermore, obesity had a significant independent association with critical illness.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pediatric Obesity / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Humans Country/Region as subject: North America Language: English Journal: Hosp Pediatr Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pediatric Obesity / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Humans Country/Region as subject: North America Language: English Journal: Hosp Pediatr Year: 2021 Document Type: Article