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Obesity Linked to Greater Severity of Pediatric COVID-19

Obesity is significantly associated with mechanical ventilation in children aged 2 years and older

WEDNESDAY, June 10, 2020 (HealthDay News) — Obesity is the most common comorbidity among children and adolescents with COVID-19 and is associated with disease severity, according to a study published online June 3 in JAMA Pediatrics.

Philip Zachariah, M.D., from Columbia University Irving Medical Center in New York City, and colleagues conducted a retrospective review of electronic medical records from a tertiary care children’s hospital in New York City for 50 hospitalized children and adolescents who tested positive for COVID-19 between March 1 and April 15, 2020.

The researchers found that most patients had fever or respiratory symptoms (80 and 64 percent, respectively); 6 percent were identified with only gastrointestinal tract presentations. The most prevalent comorbidity was obesity (22 percent); an additional 16 percent of patients were overweight. Overall, 16 patients required respiratory support, including nine who needed mechanical ventilation. One patient died. Severe disease occurred in none of 14 infants and one of eight immunocompromised patients. In children aged 2 years or older, obesity was significantly associated with mechanical ventilation (six of nine [67 percent] with severe disease versus five of 25 [20 percent] with nonsevere disease). At admission, lymphopenia was common (72 percent), with no difference for those with and without severe disease. Significantly higher C-reactive protein and procalcitonin levels were seen for those with severe disease; in addition, peak interleukin 6, ferritin, and D-dimer levels were elevated during hospitalization.

“Going forward, multicenter collaborative studies are needed to define the infectious and postinfectious sequelae of COVID-19 in children in communities across the United States,” write the authors of an accompanying editorial.

Two authors disclosed financial ties to the biopharmaceutical industry.

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