Short-term complications and post-acute sequelae in hospitalized paediatric patients with COVID-19 and obesity: A multicenter cohort study.
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Valenzuela Gonzalo, Alarcón-Andrade Gonzalo, Schulze-Schiapacasse Clara, Rodríguez Rocío, García-Salum Tamara, Pardo-Roa Catalina, Levican Jorge, Serrano Eileen, Avendaño María José, Gutiérrez Monserrat, Godoy Loreto, Céspedes Pamela, Bermudez Sandra, Aravena Javiera, Nicolaides Irini, Martínez Eliana, Gómez-Canobbio Constanza, Jofré Macarena, Salinas Andrea, Depaoli Daniela, Loza Carolina, Muñoz Andrés, Ormazábal Natalia, Manzur Diana, Barriga José, Almonacid Leonardo I, Poblete-Cárdenas Estefany, Salinas Erick, Muñoz-Marcos Andrés, Barja Salesa, Medina Rafael A
Аннотация
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.