TY - JOUR
T1 - The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19
AU - Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
AU - Tripathi, Sandeep
AU - Christison, Amy L.
AU - Levy, Emily
AU - McGravery, Jeremy
AU - Tekin, Aysun
AU - Bolliger, Dawn
AU - Kumar, Vishakha K.
AU - Bansal, Vikas
AU - Chiotos, Kathleen
AU - Gist, Katja M.
AU - Dapul, Heda R.
AU - Bhalala, Utpal S.
AU - Gharpure, Varsha P.
AU - Heneghan, Julia A.
AU - Gupta, Neha
AU - Bjornstad, Erica C.
AU - Montgomery, Vicki L.
AU - Walkey, Allan
AU - Kashyap, Rahul
AU - Arteaga, Grace M.
AU - Kovacevic, Tanja
AU - Markic, Josko
AU - Ardalic, Tatjana Catipovic
AU - Polic, Branka
AU - Ivić, Ivo
AU - Carev, Dominko
AU - Glavinic, Robert
AU - Raju, Umamaheswara
AU - Manduva, Janaki
AU - Kolakani, Naresh
AU - Sripathi, Shreeja
AU - Chaitanya, Sheetal
AU - Mohan, Surapaneni Krishna
AU - Jyothisree, Ekambaram
AU - Ishaque, Sidra
AU - Saleem, Ali Faisal
AU - Siddiqui, Naveed Ur Rehman
AU - Sherali, Salima
AU - Hashwani, Yasmin
AU - Ishaque, Shafia
AU - Asghar, Muhammad Sohaib
AU - Syed, Mashaal
AU - Naqvi, Syed Anosh Ali
AU - Almazyad, Mohammed A.
AU - Alarifi, Mohammed I.
AU - Macarambon, Jara M.
AU - Bukhari, Ahmad Abdullah
AU - Albahrani, Hussain A.
AU - Shlomovich, Mark
AU - Gupta, Manoj K.
N1 - Funding Information:
FINANCIAL DISCLOSURE: E.R.L. receives funding from the Centers for Disease Control and Prevention (CDC) (Subcontract of Federal Contract: 75D30120C07725) and the National Institute of Allergy and Infectious Diseases (National Institute of Allergy and Infectious Diseases Federal Contract: AI144301). They had no influence on the acquisition, analysis, interpretation, and reporting of pooled data for this manuscript. K.C. funded by Agency for Healthcare Research and Quality [K12-HS026393]. No conflict of interest. R.K. receives funding from the National Institutes of Health/National Heart, Lung and Blood Institute: R01HL 130881, UG3/UH3HL 141722; Gordon and Betty Moore Foundation Janssen Research & Development, LLC; and royalties from Ambient Clinical Analytics. Inc. They had no influence on the acquisition, analysis, interpretation, and reporting of pooled data for this manuscript. V.K.K. receives funding from the Gordon and Betty Moore Foundation, CDC Foundation through the University of Washington, and Janssen Research & Development, LLC. They had no influence on the acquisition, analysis, interpretation, and reporting of pooled data for this manuscript. U.S.B is currently funded by National Institutes of Health (Site-principal investigator for Stress Hydrocortisone in Pediatric Septic Shock - R01HD096901), The Children's Hospital of Philadelphia (Site-PI for Pediatric Resuscitation Quality Collaborative - PediResQ), Voelcker Pilot Grant (principal investigator for a project on Pre-Arrest Electrocardiographic Changes), The Children's Hospital of San Antonio Endowed Chair Funds for ancillary projects related to SCCM VIRUS (COVID-19) Registry and SCCM VIRUS EMR automation pilot. No conflict of interest. A.L.C. is funded by the National Institute of Allergy and Infectious Disease: U01AI138907. All other authors have indicated they have no financial relationships relevant to this article to disclose.
Publisher Copyright:
Copyright © 2021 by the American Academy of Pediatrics.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85118408374&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85118408374&partnerID=8YFLogxK
U2 - 10.1542/hpeds.2021-006087
DO - 10.1542/hpeds.2021-006087
M3 - Article
C2 - 34168067
AN - SCOPUS:85118408374
SN - 2154-1663
VL - 11
SP - E297-E307
JO - Hospital Pediatrics
JF - Hospital Pediatrics
IS - 11
ER -
