The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19

Sandeep Tripathi; Amy L Christison; Emily Levy; Jeremy McGravery; Aysun Tekin; Dawn Bolliger; Vishakha K Kumar; Vikas Bansal; Kathleen Chiotos; Katja M Gist; Heda R Dapul; Utpal S Bhalala; Varsha P Gharpure; Julia A Heneghan; Neha Gupta; Erica C Bjornstad; Vicki L Montgomery; Allan Walkey; Rahul Kashyap; Grace M Arteaga; Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group

doi:10.1542/hpeds.2021-006087

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The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19

Journal article

Open access

Peer reviewed

The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19

Sandeep Tripathi, Amy L Christison, Emily Levy, Jeremy McGravery, Aysun Tekin, Dawn Bolliger, Vishakha K Kumar, Vikas Bansal, Kathleen Chiotos, Katja M Gist, …

Hospital pediatrics, Vol.11(11), pp.e297-e316

11/2021

DOI: 10.1542/hpeds.2021-006087

PMID: 34168067

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Abstract

To describe the impact of obesity on disease severity and outcomes of coronavirus disease 2019 (COVID-19) among hospitalized children. 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. 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%, = .04) and had higher ICU admission rates (57% vs 44%, < .01) with more critical illness (30.3% vs 18.3%, < .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%, = .38). 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.

Comorbidity

Adolescent

Child

Child, Hospitalized

COVID-19 - complications

Hospitalization

Humans

Pediatric Obesity - complications

Retrospective Studies

Severity of Illness Index

Systemic Inflammatory Response Syndrome

United States - epidemiology

Details

Title: Subtitle: The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19
Creators: Sandeep Tripathi - OSF Saint Francis Medical Center
Amy L Christison - Peoria campus of the University of Illinois System
Emily Levy - Mayo Clinic , Rochester, Minnesota.
Jeremy McGravery - OSF Saint Francis Medical Center
Aysun Tekin - Mayo Clinic , Rochester, Minnesota.
Dawn Bolliger - OSF Saint Francis Medical Center
Vishakha K Kumar - Society of Critical Care Medicine
Vikas Bansal - Mayo Clinic , Rochester, Minnesota.
Kathleen Chiotos - Children's Hospital of Philadelphia
Katja M Gist - University of Colorado Anschutz Medical Campus
Heda R Dapul - Hassenfeld Children's Hospital at NYU Langone;
Utpal S Bhalala - Children's Hospital of San Antonio
Varsha P Gharpure - Advocate Children's Hospital
Julia A Heneghan - University of Minnesota
Neha Gupta - University of Oklahoma
Erica C Bjornstad - University of Alabama at Birmingham
Vicki L Montgomery - University of Louisville
Allan Walkey - Boston University
Rahul Kashyap - Mayo Clinic , Rochester, Minnesota.
Grace M Arteaga - Mayo Clinic , Rochester, Minnesota.
Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Contributors: Patrick W McGonagill (Contributor) - University of Iowa, Surgery
Resource Type: Journal article
Publication Details: Hospital pediatrics, Vol.11(11), pp.e297-e316
DOI: 10.1542/hpeds.2021-006087
PMID: 34168067
NLM abbreviation: Hosp Pediatr
ISSN: 2154-1663
eISSN: 2154-1671
Grant note: U19 AI144301 / NIAID NIH HHS R01 HD096901 / NICHD NIH HHS UH3 HL141722 / NHLBI NIH HHS R01 HL130881 / NHLBI NIH HHS K12 HS026393 / AHRQ HHS U01 AI138907 / NIAID NIH HHS
Language: English
Date published: 11/2021
Academic Unit: Surgery
Record Identifier: 9984322943702771

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