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Liu Y, Miu Y, Zhang N, Yu W, Chen Y, Zhang J, Zhang B. Evaluating the impact of childhood BMI on the risk of coronavirus disease 2019: A Mendelian randomization study. Open Med (Wars) 2024; 19:20240923. [PMID: 38584826 PMCID: PMC10996998 DOI: 10.1515/med-2024-0923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 01/02/2024] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Although the correlation between childhood obesity and coronavirus disease 2019 (COVID-19) has been explored, the causality of these remains uncertain. Thus, we conducted a two-sample Mendelian randomization (MR) analysis to identify the causal association. Methods Instrumental variables of childhood obesity were selected from genome-wide association study involving 61,111 Europeans. Besides, we collected summary statistics of different COVID-19 outcomes (susceptibility, hospitalization, and severity) from genome-wide association study including more than 2 million Europeans. The inverse-variance weighted was applied to assess the causality of childhood obesity with COVID-19. Furthermore, we replicated the above association based on another study. Results Inverse-variance weighted results suggested that childhood obesity promoted the COVID-19 susceptibility but has not been validated in other approaches. For hospitalization and severity of COVID-19, we found that childhood obesity, respectively, increased 30 and 38% risk (P < 0.001), which were consistent in other MR approaches. Discussion Our study provides evidence for a causal relationship between childhood BMI and COVID-19 which is consistent with previous studies. Though these explanations are biologically plausible, further studies are warranted to elucidate the role of these. Conclusions Our study suggests the potential causal associations of childhood obesity with COVID-19, especially hospitalization and severity of COVID-19.
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Affiliation(s)
- Yuan Liu
- Department of Infectious Disease Control, Wenling Center for Disease Control and Prevention, Taizhou317500, China
| | - Yujian Miu
- Department of Infectious Disease Control, Wenling Center for Disease Control and Prevention, Taizhou317500, China
| | - Ningjie Zhang
- Department of Infectious Disease Control, Wenling Center for Disease Control and Prevention, Taizhou317500, China
| | - Wenhao Yu
- Department of Infectious Disease Control, Wenling Center for Disease Control and Prevention, Taizhou317500, China
| | - Yu Chen
- Department of Infectious Disease Control, Wenling Center for Disease Control and Prevention, Taizhou317500, China
| | - Jianli Zhang
- Department of Infectious Disease Control, Wenling Center for Disease Control and Prevention, Taizhou317500, China
| | - Bo Zhang
- Department of Orthopedics, First People’s Hospital of Wenling Affiliated to Wenzhou Medical University, 190 Taiping South Road, Taizhou317500, China
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Jiang RM, Xie ZD, Jiang Y, Lu XX, Jin RM, Zheng YJ, Shang YX, Xu BP, Liu ZS, Lu G, Deng JK, Liu GH, Wang XC, Wang JS, Feng LZ, Liu W, Zheng Y, Shu SN, Lu M, Luo WJ, Liu M, Cui YX, Ye LP, Shen AD, Liu G, Gao LW, Xiong LJ, Bai Y, Lin LK, Wei Z, Xue FX, Wang TY, Zhao DC, Shao JB, Ng DKK, Wong GWK, Zhao ZY, Li XW, Yang YH, Shen KL. Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts' consensus statement updated for the Omicron variant. World J Pediatr 2024; 20:272-286. [PMID: 37676610 DOI: 10.1007/s12519-023-00745-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 06/29/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Rong-Meng Jiang
- Diagnosis and Treatment Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Zheng-De Xie
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yi Jiang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xiao-Xia Lu
- Department of Respiratory, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, China
| | - Run-Ming Jin
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yue-Jie Zheng
- Department of Respiratory, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Yun-Xiao Shang
- Department of Pediatric Respiratory, Shengjing Hospital Affiliated to China Medical University, Shenyang, 110004, China
| | - Bao-Ping Xu
- Department of Respiratory, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, 100045, China
| | - Zhi-Sheng Liu
- Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, China
| | - Gen Lu
- Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, China
| | - Ji-Kui Deng
- Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, 518038, China
| | - Guang-Hua Liu
- Department of Pediatrics, Fujian Branch of Shanghai Children's Medical Center, Fujian Children's Hospital, Fuzhou, 350005, China
| | - Xiao-Chuan Wang
- Department of Clinical Immunology and Allergy, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, 201102, China
| | - Jian-She Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, 201102, China
| | - Lu-Zhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Wei Liu
- Children's Hospital of Tianjin University, Tianjin Children's Hospital, Tianjin, 300134, China
| | - Yi Zheng
- Beijing Key Laboratory of Diagnosis and Treatment of Mental Disorders, National Clinical Research Center for Mental and Psychological Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Sai-Nan Shu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Min Lu
- Department of Respiratory, Shanghai Children's Hospital, Shanghai, 200062, China
| | - Wan-Jun Luo
- Office of Infection Management, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, China
| | - Miao Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yu-Xia Cui
- Department of Pediatrics, Guizhou Provincial People's Hospital, Guiyang, 550002, China
| | - Le-Ping Ye
- Department of Pediatrics, Peking University First Hospital, Beijing, 100034, China
| | - A-Dong Shen
- Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, 100045, China
| | - Gang Liu
- Department of Infectious Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Li-Wei Gao
- Department of Respiratory, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, 100045, China
| | - Li-Juan Xiong
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yan Bai
- Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li-Kai Lin
- Hospital Management Institute of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Zhuang Wei
- Children's Health Care Center, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Feng-Xia Xue
- Department of Respiratory, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, 100045, China
| | - Tian-You Wang
- Hematology and Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Dong-Chi Zhao
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jian-Bo Shao
- Department of Radiology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, China
| | - Daniel Kwok-Keung Ng
- Department of Pediatrics, Hong Kong Sanatorium & Hospital, Hong Kong, 999077, China
| | - Gary Wing-Kin Wong
- Department of Pediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, 999077, China
| | - Zheng-Yan Zhao
- Department of Developmental Behavior, Children's Hospital, Zhejiang University College of Medicine, Hangzhou, 310051, China.
| | - Xing-Wang Li
- Diagnosis and Treatment Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
| | - Yong-Hong Yang
- Department of Respiratory, Shenzhen Children's Hospital, Shenzhen, 518038, China.
- Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, 100045, China.
| | - Kun-Ling Shen
- Department of Respiratory, Shenzhen Children's Hospital, Shenzhen, 518038, China.
- Department of Respiratory, Beijing Children's Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children's Health, Beijing, 100045, China.
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Kostopoulou E. The Interplay Between COVID-19 and Pediatric Endocrine Disorders. What have we Learned After More than Three Years of the Pandemic? Horm Metab Res 2024; 56:181-192. [PMID: 37673081 DOI: 10.1055/a-2152-4590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
As an increased body of COVID-19 related research is now available, it becomes apparent that the effects of COVID-19 extend beyond that of the respiratory system. Among others, the endocrine system is particularly vulnerable to perturbation from the COVID-19 infection. The present scoping review summarizes the bidirectional relationship between COVID-19 and endocrine system in children and adolescents, by describing both the possible susceptibility of children and adolescents without endocrinopathies to endocrine disorders following COVID-19 infection, but also the potential susceptibility to COVID-19 infection and severe infection, or the aggravation of endocrine dysfunction in patients with pre-existing endocrine diseases. Data suggest increased obesity and diabetes rates, as well as increased severity and frequency of diabetic ketoacidosis following COVID-19 infection. Conversely, patients with diabetes and obesity may experience a more severe course of COVID-19 infection. However, in the majority of cases, children and adolescents with well-managed and regulated endocrine disorders do not appear to be at increased risk of infection or severe infection from COVID-19. Thus, adhering to the appropriate "sick day management rules", maintaining adequate supply of medications and supplies, keeping close contact with the therapeutic team and seeking medical help without delay when needed, are the main recommendations for a safe outcome. Additional lessons learnt during the pandemic include the risk for mental health diseases caused by children's disrupted routine due to COVID-19 related protective measures and the importance of adopting alternative communication options, such as telehealth visits, in order to ensure uninterrupted endocrine care.
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Affiliation(s)
- Eirini Kostopoulou
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, University of Patras School of Medicine, Patras, Greece
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4
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Tantivit N, Mulekar M, Kaulfers AM, Lim WY. Impact of Weight on Severity of Hospital Course in Children Admitted With COVID-19. Glob Pediatr Health 2023; 10:2333794X231220873. [PMID: 38143516 PMCID: PMC10748557 DOI: 10.1177/2333794x231220873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/26/2023] Open
Abstract
Objective. To describe the impact of weight on length of stay (LOS) and oxygen requirement among hospitalized children with COVID-19. Methods. This is a retrospective review of 153 children admitted for COVID-19 from March 2020 to October 2021. Body mass index (BMI) percentile and weight-for-age (WFA) percentile were used to determine weight status for children ≥2 years and <2 years respectively. Results. We found 2 distinct patterns for patients <2 years and ≥2 years; The likelihood of needing oxygen and LOS ≥ 5 days was higher for children ≥2 years with BMI ≥ 85th percentile (P = .0415 and P = .0197). Among those <2 years, mean WFA percentile decreased with increasing oxygen need (P = .0325). There was a negative correlation between LOS and WFA percentile (r = -.31, P = .0123). Conclusion. It is important to stratify patients' risk according to their age, BMI and WFA percentile during hospitalization for COVID 19.
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Khoury M, Harahsheh AS, Raghuveer G, Dahdah N, Lee S, Fabi M, Selamet Tierney ES, Portman MA, Choueiter NF, Elias M, Thacker D, Dallaire F, Orr WB, Harris TH, Norozi K, Truong DT, Khare M, Szmuszkovicz JR, Pagano JJ, Manlhiot C, Farid P, McCrindle BW. Obesity and Outcomes of Kawasaki Disease and COVID-19-Related Multisystem Inflammatory Syndrome in Children. JAMA Netw Open 2023; 6:e2346829. [PMID: 38064213 PMCID: PMC10709775 DOI: 10.1001/jamanetworkopen.2023.46829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/23/2023] [Indexed: 12/18/2023] Open
Abstract
Importance Obesity may affect the clinical course of Kawasaki disease (KD) in children and multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. Objective To compare the prevalence of obesity and associations with clinical outcomes in patients with KD or MIS-C. Design, Setting, and Participants In this cohort study, analysis of International Kawasaki Disease Registry (IKDR) data on contemporaneous patients was conducted between January 1, 2020, and July 31, 2022 (42 sites, 8 countries). Patients with MIS-C (defined by Centers for Disease Control and Prevention criteria) and patients with KD (defined by American Heart Association criteria) were included. Patients with KD who had evidence of a recent COVID-19 infection or missing or unknown COVID-19 status were excluded. Main Outcomes and Measures Patient demographic characteristics, clinical features, disease course, and outcome variables were collected from the IKDR data set. Using body mass index (BMI)/weight z score percentile equivalents, patient weight was categorized as normal weight (BMI <85th percentile), overweight (BMI ≥85th to <95th percentile), and obese (BMI ≥95th percentile). The association between adiposity category and clinical features and outcomes was determined separately for KD and MIS-C patient groups. Results Of 1767 children, 338 with KD (median age, 2.5 [IQR, 1.2-5.0] years; 60.4% male) and 1429 with MIS-C (median age, 8.7 [IQR, 5.3-12.4] years; 61.4% male) were contemporaneously included in the study. For patients with MIS-C vs KD, the prevalence of overweight (17.1% vs 11.5%) and obesity (23.7% vs 11.5%) was significantly higher (P < .001), with significantly higher adiposity z scores, even after adjustment for age, sex, and race and ethnicity. For patients with KD, apart from intensive care unit admission rate, adiposity category was not associated with laboratory test features or outcomes. For patients with MIS-C, higher adiposity category was associated with worse laboratory test values and outcomes, including a greater likelihood of shock, intensive care unit admission and inotrope requirement, and increased inflammatory markers, creatinine levels, and alanine aminotransferase levels. Adiposity category was not associated with coronary artery abnormalities for either MIS-C or KD. Conclusions and Relevance In this international cohort study, obesity was more prevalent for patients with MIS-C vs KD, and associated with more severe presentation, laboratory test features, and outcomes. These findings suggest that obesity as a comorbid factor should be considered at the clinical presentation in children with MIS-C.
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Affiliation(s)
- Michael Khoury
- Division of Pediatric Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Ashraf S Harahsheh
- Children's National Hospital, The George Washington University School of Medicine & Health Sciences, Washington, DC
| | | | - Nagib Dahdah
- Division of Pediatric Cardiology, CHU Ste-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Simon Lee
- The Heart Center at Nationwide Children's Hospital, Columbus, Ohio
| | - Marianna Fabi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | | | | | - Nadine F Choueiter
- Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Matthew Elias
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Frédéric Dallaire
- Department of Pediatrics, Universite de Sherbrooke, and Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - William B Orr
- Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
| | - Tyler H Harris
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kambiz Norozi
- Department of Pediatrics, Pediatric Cardiology, Western University, London, Ontario, Canada
| | | | - Manaswitha Khare
- University of California San Diego/Rady Children's Hospital San Diego
| | | | - Joseph J Pagano
- Division of Pediatric Cardiology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Cedric Manlhiot
- Blalock-Taussig-Thomas Congenital Heart Center at Johns Hopkins University, Baltimore, Maryland
| | - Pedrom Farid
- Labatt Family Heart Centre, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Brian W McCrindle
- Labatt Family Heart Centre, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Oktaviani S, Mizutani M, Nishide R, Tanimura S. Factors associated with overweight/obesity of children aged 6-12 years in Indonesia. BMC Pediatr 2023; 23:484. [PMID: 37749512 PMCID: PMC10518961 DOI: 10.1186/s12887-023-04321-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 09/19/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Globally, the prevalence of childhood obesity has increased considerably, including in Indonesia. Obesity results from multifactorial interactions at the personal, familial, and environmental levels. However, little is known about the factors associated with overweight/obesity among children in Indonesia. This study is intended to identify personal, familial, and environmental factors associated with overweight/obesity in children aged 6-12 years in Indonesia. METHODS Study design was a secondary data analysis using the Indonesia Family Life Survey in 2014/2015, focusing on 6,090 children aged 6-12 years. The questions covered the child's body mass index and potential personal, familial, and environmental factors. Logistic regression analysis was performed to identify the personal, familial, and environmental factors. RESULTS The mean age of participants was 8.9 years (SD = 2.0); 51.0% were boys; 9.4% were overweight; and 8.1% were obese. Overweight and obesity were associated with age [AOR 1.09 (95% CI 1.04-1.14)], having an overweight [AOR 1.93 (95% CI 1.58-2.36)] or obese [AOR 3.36 (95% CI 2.43-4.61)] father compared with a normal father, being of Chinese [AOR 9.51 (95% CI 1.43-79.43)] or Javanese [AOR 1.60 (95% CI 1.16-2.24)] ethnicity compared with Sundanese ethnicity, and residing in an urban area [AOR 1.36 (95% CI 1.10-1.70)]. A lower risk of child overweight/obesity was associated with the father's perception [AOR 0.56 (95% CI 0.38-0.80)] and mother's perception [AOR 0.66 (95% CI 0.43-0.98)] of the child's food consumption as being less than adequate compared with adequate. CONCLUSIONS Risk factors in children for overweight/obesity were older age, having an overweight/obese father, membership of certain ethnic groups, and urban residence. The main protective factor was parents' perception that a child's food consumption was less than adequate. Health promotion programs focused on these factors could help control or prevent childhood obesity in Indonesia.
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Affiliation(s)
- Sofi Oktaviani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
- Indramayu College of Health Science, Indramayu, Indonesia
| | - Mayumi Mizutani
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Ritsuko Nishide
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
| | - Susumu Tanimura
- Department of Public Health Nursing, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan
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Memar EHE, Mohsenipour R, Sadrosadat ST, Rostami P. Pediatric endocrinopathies related to COVID-19: an update. World J Pediatr 2023; 19:823-834. [PMID: 36480134 PMCID: PMC9734372 DOI: 10.1007/s12519-022-00662-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the seventh coronavirus to be linked to human disease. The SARS-CoV-2 virus may have several pathophysiologic interactions with endocrine systems, resulting in disruptions in glucose metabolism, hypothalamus and pituitary function, adrenal function, and mineral metabolism. An increasing amount of evidence demonstrates both the influence of underlying endocrine abnormalities on the outcome of COVID-19 and the effect of the SARS-CoV-2 virus on endocrine systems. However, a systematic examination of the link to pediatric endocrine diseases has been missing. DATA SOURCES The purpose of this review is to discuss the impact of SARS-CoV-2 infection on endocrine systems and to summarize the available knowledge on COVID-19 consequences in children with underlying endocrine abnormalities. For this purpose, a literature search was conducted in EMBASE, and data that were discussed about the effects of COVID-19 on endocrine systems were used in the current study. RESULTS Treatment suggestions were provided for endocrinopathies associated with SARS-CoV-2 infection. CONCLUSIONS With the global outbreak of COVID-19, it is critical for pediatric endocrinologists to understand how SARS-CoV-2 interacts with the endocrine system and the therapeutic concerns for children with underlying problems who develop COVID-19. While children and adults share certain risk factors for SARS-CoV-2 infection sequelae, it is becoming obvious that pediatric responses are different and that adult study results cannot be generalized. While pediatric research gives some insight, it also shows the need for more study in this area.
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Affiliation(s)
| | - Reihaneh Mohsenipour
- Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Taravat Sadrosadat
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Parastoo Rostami
- Growth and Development Research Center, Department of Endocrinology and Metabolism, Pediatric Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
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8
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Cáceres C, Castillo M, Carrillo K, Tapia CV, Valderrama G, Maquilón C, Toro-Ascuy D, Zorondo-Rodríguez F, Fuenzalida LF. Overnutrition as a risk factor for more serious respiratory viral infections in children: A retrospective study in hospitalized patients. ENDOCRINOL DIAB NUTR 2023; 70:476-483. [PMID: 37527958 DOI: 10.1016/j.endien.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/03/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The prevalence of obesity has increased dramatically in children worldwide. Obesity has been recognized as a risk factor for more serious viral respiratory infections, mainly in adults. OBJECTIVE To study the relationship between overnutrition (obesity and overweight) and clinical severity in children hospitalized with acute respiratory infections of viral origin. METHODS One hundred and forty-three clinical records of children between 2 and 18 years old hospitalized for acute respiratory infection at Clínica Dávila (2014-2018) were analyzed, recording the respiratory viruses detected at the time of hospitalization, weight, and height. Nutritional status was estimated using Z score or body mass index, according to age. RESULTS Eighty-tree3 children (58%) were positive for more than one respiratory virus. The main virus detected in monoinfection was adenovirus (9.8%), followed by respiratory syncytial virus (7.7%) and parainfluenza virus (7.7%). There were no deaths. Patients with obesity presented more days of hospitalization (P = .04), oxygen therapy (P = .03) and mechanical ventilation (P < .001), as well as a higher probability of requiring mechanical ventilation (P = .001) and of ICU admission (P = .003) compared with children with normal weight. Patients with overweight presented more days of mechanical ventilation (P < .001) than patients with normal weight. No significant differences were found between the presence of viral coinfection and nutritional status. CONCLUSION Overnutrition is associated with greater severity of viral respiratory infection in hospitalized children.
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Affiliation(s)
- Camila Cáceres
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Macarena Castillo
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Karin Carrillo
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | | | | | - César Maquilón
- Unidad Broncopulmonar Adulto, Clínica Dávila, Santiago, Chile
| | - Daniela Toro-Ascuy
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | | | - Loreto F Fuenzalida
- Facultad de Ciencias de la Salud, Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile.
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9
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Ferrulli A, Terruzzi I, Zuccotti G, Luzi L. Editorial for the Special Issue "Effects of COVID-19 on Lifestyle Behaviors in Children with Obesity". Nutrients 2023; 15:2652. [PMID: 37375556 DOI: 10.3390/nu15122652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
During the last four decades, the prevalence of obesity has increased dramatically worldwide; concomitantly, a progressive rise in the prevalence of obesity, diabetes, and other nutrition-related chronic diseases has also been observed in childhood [...].
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Affiliation(s)
- Anna Ferrulli
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Ileana Terruzzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Biomedical and Clinical Sciences, University of Milan, 20157 Milan, Italy
- Department of Pediatrics, Buzzi Children's Hospital, 20157 Milan, Italy
| | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20138 Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
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Hashemian H, Esfandiari MA, Dalili S. Childhood Body Mass Index (BMI) and the Risk of Infection: A Narrative Review. JOURNAL OF COMPREHENSIVE PEDIATRICS 2023; 14. [DOI: 10.5812/compreped-135110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 09/13/2023]
Abstract
Context: Infectious diseases are still one of the main causes of morbidity and mortality in children, especially in developing countries. In various studies, the weight of children has been found to be influential in the risk of occurrence of these diseases or their severity, and sufficient information on this matter can be important in improving the management and prognosis of patients. This study aimed to determine the impact of being underweight or obese on the risk of infection in children Evidence Acquisition: The ISI Web of Sciences, Scopus, PubMed, and Google Scholar databases were reviewed for relevant articles published from 2010 to 2022. The keywords used included: Infections, body mass index, obesity, thinness, underweight, and child. Results: Studies show that underweight children are associated with an increased risk of various parasitic, viral, and bacterial infections or their severity. Being overweight and obese have received less attention, but they have been shown to be effective in some respiratory and urinary infections in children. Conclusions: According to obtained results, being underweight or obese has been linked to an increased risk of various parasitic, viral, and bacterial infections or their severity in children. Therefore, determining the weight of children, even in emergency cases, and considering it, along with other initial evaluations of children with infection, can be effective in improving the management and prognosis of these children.
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11
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Solórzano-Santos F, Miranda-Lora AL, Márquez-González H, Klünder-Klünder M. Survival analysis and mortality predictors of COVID-19 in a pediatric cohort in Mexico. Front Public Health 2022; 10:969251. [PMID: 36589967 PMCID: PMC9801985 DOI: 10.3389/fpubh.2022.969251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
Background The new coronavirus SARS-CoV-2 pandemic has been relatively less lethal in children; however, poor prognosis and mortality has been associated with factors such as access to health services. Mexico remained on the list of the ten countries with the highest case fatality rate (CFR) in adults. It is of interest to know the behavior of COVID-19 in the pediatric population. The aim of this study was to identify clinical and sociodemographic variables associated with mortality due to COVID-19 in pediatric patients. Objective Using National open data and information from the Ministry of Health, Mexico, this cohort study aimed to identify clinical and sociodemographic variables associated with COVID-19 mortality in pediatric patients. Method A cohort study was designed based on National open data from the Ministry of Health, Mexico, for the period April 2020 to January 2022, and included patients under 18 years of age with confirmed SARS-CoV-2 infection. Variables analyzed were age, health services used, and comorbidities (obesity, diabetes, asthma, cardiovascular disease, immunosuppression, high blood pressure, and chronic kidney disease). Follow-up duration was 60 days, and primary outcomes were death, hospitalization, and requirement of intensive care. Statistical analysis included survival analysis, prediction models created using the Cox proportional hazards model, and Kaplan-Meier estimation curves. Results The cohort included 261,099 cases with a mean age of 11.2 ± 4 years, and of these, 11,569 (4.43%) were hospitalized and 1,028 (0.39%) died. Variables associated with risk of mortality were age under 12 months, the presence of comorbidities, health sector where they were treated, and first wave of infection. Conclusion Based on data in the National database, we show that the pediatric fatality rate due to SARS-CoV-2 is similar to that seen in other countries. Access to health services and distribution of mortality were heterogeneous. Vulnerable groups were patients younger than 12 months and those with comorbidities.
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Affiliation(s)
- Fortino Solórzano-Santos
- Unidad de Investigación en Enfermedades Infecciosas, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico
| | - América Liliana Miranda-Lora
- Unidad de Investigación Epidemiológica en Endocrinología y Nutrición, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico
| | - Horacio Márquez-González
- Departamento de Investigación Clínica, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico,*Correspondence: Horacio Márquez-González
| | - Miguel Klünder-Klünder
- Subdirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Ciudad de México, Mexico,Miguel Klünder-Klünder
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12
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Vekaria PH, Syed A, Anderson J, Cornett B, Bourbia A, Flynn MG, Kashyap R, Shah AR. Association of dementia and patient outcomes among COVID-19 patients: A multi-center retrospective case-control study. Front Med (Lausanne) 2022; 9:1050747. [PMID: 36419792 PMCID: PMC9676493 DOI: 10.3389/fmed.2022.1050747] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/20/2022] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND We conducted a retrospective cohort study on COVID-19 patients with and without dementia by extracting data from the HCA Healthcare Enterprise Data Warehouse between January-September 2020. AIMS To describe the role of patients' baseline characteristics specifically dementia in determining overall health outcomes in COVID-19 patients. METHODS We grouped in-patients who had ICD-10 codes for dementia (DM) with age and gender-matched (1:2) patients without dementia (ND). Our primary outcome variables were in-hospital mortality, length of stay, Intensive Care Unit (ICU) admission, ICU-free days, mechanical ventilation (MV) use, MV-free days and 90-day re-admission. RESULTS Matching provided similar age and sex in DM and ND groups. BMI (median, 25.8 vs. 27.6) and proportion of patients who had smoked (23.3 vs. 31.3%) were lower in DM than in ND patients. The median (IQR) Elixhauser Comorbidity Index was higher in dementia patients 7 (5-10) vs. 5 (3-7, p < 0.01). Higher mortality was observed in DM group (30.8%) vs. ND group (26.4%, p < 0.01) as an unadjusted univariate analysis. The 90-day readmission was not different (32.1 vs. 31.8%, p = 0.8). In logistic regression analysis, the odds of dying were not different between patients in DM and ND groups (OR = 1.0; 95% CI 0.86-1.17), but the odds of ICU admissions were significantly lower for dementia patients (OR = 0.58, 95% CI 0.51-0.66). CONCLUSIONS Our data showed that COVID-19 patients with dementia did not fare substantially worse, but in fact, fared better when certain metrics were considered.
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Affiliation(s)
- Pratikkumar H. Vekaria
- Prisma Health-Upstate, Greenville, SC, United States
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | - Areej Syed
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | | | | | - Amine Bourbia
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
| | | | - Rahul Kashyap
- HCA Healthcare, Nashville, TN, United States
- Mayo Clinic, Rochester, MN, United States
| | - Asif R. Shah
- Redmond Regional Medical Center, Advent Health, Rome, GA, United States
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13
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Tripathi S, Nadiger M, McGarvey JS, Harthan AA, Lombardo M, Gharpure VP, Perkins N, Chiotos K, Sayed IA, Bjornstad EC, Bhalala US, Raju U, Miller AS, Dapul H, Montgomery V, Boman K, Arteaga GM, Bansal V, Deo N, Tekin A, Gajic O, Kumar VK, Kashyap R, Walkey AJ. Association of Early Steroid Administration With Outcomes of Children Hospitalized for COVID-19 Without Multisystem Inflammatory Syndrome in Children. JAMA Pediatr 2022; 176:2796975. [PMID: 36190706 PMCID: PMC9531079 DOI: 10.1001/jamapediatrics.2022.3611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/13/2022] [Indexed: 12/15/2022]
Abstract
Importance There is limited evidence for therapeutic options for pediatric COVID-19 outside of multisystem inflammatory syndrome in children (MIS-C). Objective To determine whether the use of steroids within 2 days of admission for non-MIS-C COVID-19 in children is associated with hospital length of stay (LOS). The secondary objective was to determine their association with intensive care unit (ICU) LOS, inflammation, and fever defervescence. Design, Setting, and Participants This cohort study analyzed data retrospectively for children (<18 years) who required hospitalization for non-MIS-C COVID-19. Data from March 2020 through September 2021 were provided by 58 hospitals in 7 countries who participate in the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 registry. Exposure Administration of steroids within 2 days of admission. Main Outcomes and Measures Length of stay in the hospital and ICU. Adjustment for confounders was done by mixed linear regression and propensity score matching. Results A total of 1163 patients met inclusion criteria and had a median (IQR) age of 7 years (0.9-14.3). Almost half of all patients (601/1163, 51.7%) were male, 33.8% (392/1163) were non-Hispanic White, and 27.9% (324/1163) were Hispanic. Of the study population, 184 patients (15.8%) received steroids within 2 days of admission, and 979 (84.2%) did not receive steroids within the first 2 days. Among 1163 patients, 658 (56.5%) required respiratory support during hospitalization. Overall, patients in the steroids group were older and had greater severity of illness, and a larger proportion required respiratory and vasoactive support. On multivariable linear regression, after controlling for treatment with remdesivir within 2 days, country, race and ethnicity, obesity and comorbidity, number of abnormal inflammatory mediators, age, bacterial or viral coinfection, and disease severity according to ICU admission within first 2 days or World Health Organization ordinal scale of 4 or higher on admission, with a random intercept for the site, early steroid treatment was not significantly associated with hospital LOS (exponentiated coefficient, 0.94; 95% CI, 0.81-1.09; P = .42). Separate analyses for patients with an LOS of 2 days or longer (n = 729), those receiving respiratory support at admission (n = 286), and propensity score-matched patients also showed no significant association between steroids and LOS. Early steroid treatment was not associated with ICU LOS, fever defervescence by day 3, or normalization of inflammatory mediators. Conclusions and Relevance Steroid treatment within 2 days of hospital admission in a heterogeneous cohort of pediatric patients hospitalized for COVID-19 without MIS-C did not have a statistically significant association with hospital LOS.
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Affiliation(s)
- Sandeep Tripathi
- University of Illinois College of Medicine at Peoria and OSF HealthCare, Children's Hospital of illinois, Peoria
| | - Meghana Nadiger
- University of Illinois College of Medicine at Peoria and OSF HealthCare, Children's Hospital of illinois, Peoria
| | | | - Aaron A Harthan
- Department of Clinical Pharmacy, OSF Saint Francis Medical Center, Peoria, Illinois
| | - Monica Lombardo
- Division of Clinical Research, Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria
| | - Varsha P Gharpure
- Department of Pediatrics, Advocate Children's Hospital, Park Ridge, Illinois
| | - Nicholas Perkins
- Department of Medicine, Prisma Health, Greenville, South Carolina
| | - Kathleen Chiotos
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Imran A Sayed
- Department of Pediatrics, Children's Hospital of Colorado, University of Colorado Anschutz Medical Campus, Denver
| | | | - Utpal S Bhalala
- Children's Hospital of San Antonio, Baylor College of Medicine, San Antonio, Texas
| | | | - Aaron S Miller
- Cardinal Glennon Children's Hospital, St Louis, Missouri
| | - Heda Dapul
- Hassenfeld Children's Hospital at NYU Langone, New York, New York
| | - Vicki Montgomery
- University of Louisville and Norton Children's Hospital, Louisville, Kentucky
| | - Karen Boman
- Society of Critical Care Medicine, Chicago, Illinois
| | | | | | - Neha Deo
- Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | | | | | | | | | - Allan J Walkey
- The Pulmonary Center, Section of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
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14
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Raman V, Gupta A, Ashraf AP, Breidbart E, Gourgari E, Kamboj M, Kohn B, Krishnan S, Lahoti A, Matlock K, Mehta S, Mistry S, Miller R, Page L, Reynolds D, Han JC. Pharmacologic Weight Management in the Era of Adolescent Obesity. J Clin Endocrinol Metab 2022; 107:2716-2728. [PMID: 35932277 DOI: 10.1210/clinem/dgac418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Pediatric obesity is a serious health problem in the United States. While lifestyle modification therapy with dietary changes and increased physical activity are integral for the prevention and treatment of mild to moderate obesity in youth, only a modest effect on sustained weight reduction is observed in children and young adults with severe obesity. This underscores the need for additional evidence-based interventions for children and adolescents with severe obesity, including pharmacotherapy, before considering invasive procedures such as bariatric surgery. EVIDENCE ACQUISITION This publication focuses on recent advances in pharmacotherapy of obesity with an emphasis on medications approved for common and rarer monogenic forms of pediatric obesity. EVIDENCE SYNTHESIS We review medications currently available in the United States, both those approved for weight reduction in children and "off-label" medications that have a broad safety margin. CONCLUSION It is intended that this review will provide guidance for practicing clinicians and will encourage future exploration for successful pharmacotherapy and other interventions for obesity in youth.
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Affiliation(s)
- Vandana Raman
- Department of Pediatrics, University of Utah, Salt Lake City, Utah 84113, USA
| | - Anshu Gupta
- Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia 23219, USA
| | - Ambika P Ashraf
- Division of Pediatric Endocrinology & Diabetes, University of Alabama at Birmingham, Birmingham, Alabama, 35233, USA
| | - Emily Breidbart
- Department of Pediatrics, Division Pediatric Endocrinology and Diabetes, NYU Grossman School of Medicine, New York, New York 10016, USA
| | - Evgenia Gourgari
- Department of Pediatrics, Division of Pediatric Endocrinology, Georgetown University, Washington, District of Columbia 20007, USA
| | - Manmohan Kamboj
- Division of Pediatric Endocrinology, Nationwide Children's Hospital at The Ohio State University, Columbus, Ohio 43205, USA
| | - Brenda Kohn
- Department of Pediatrics, Division Pediatric Endocrinology and Diabetes, NYU Grossman School of Medicine, New York, New York 10016, USA
| | - Sowmya Krishnan
- Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA
| | - Amit Lahoti
- Department of Pediatrics, University of Tennessee Health Sciences Center, Le Bonheur Children's Hospital, Memphis, Tennessee 38163, USA
| | - Kristal Matlock
- Department of Pediatrics, Division of Pediatric Endocrinology, Medical University of South Carolina, Charleston, South Carolina 29425, USA
| | - Shilpa Mehta
- Department of Pediatrics, Division of Pediatric Endocrinology, New York Medical College, Valhalla, New York 10595, USA
| | - Sejal Mistry
- Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah 84108, USA
| | - Ryan Miller
- Department of Pediatrics, University of Maryland School of Medicine , Baltimore, Maryland 21093, USA
| | - Laura Page
- Department of Pediatrics, Division of Endocrinology, Department of Pediatrics, Duke University, Durham, North Carolina 27710, USA
| | - Danielle Reynolds
- Diabetes and Endocrinology Center, University of South Florida, Tampa, Florida 33620, USA
| | - Joan C Han
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
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15
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Tolopka T, Kuehne J, Mainali K, Beebe M, Garcia M, Salameh M, Ocampo R, Bhalala U. The Role of Childhood Obesity in Acute Presentations and Outcomes of Hospitalized COVID-19 Patients. Cureus 2022; 14:e28911. [PMID: 36237819 PMCID: PMC9546786 DOI: 10.7759/cureus.28911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background and objective The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has affected all regions, demographics, and age groups worldwide. However, few studies have investigated the prevalence of childhood obesity and severe COVID-19 presentation in a predominately Hispanic population. In light of this, we investigated the role of underlying obesity in COVID-19 presentations and outcomes at a tertiary care children’s hospital by using subcategories based on patients' body mass index (BMI). Methods We conducted a single-center retrospective study involving 77 pediatric patients aged 18 years and younger, who were hospitalized with suspected or verified COVID-19 between February 2020 and January 2021. We collected data on height, weight, and BMI and categorized patients based on the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) definition(s) of obesity. We also collected data on demographics, mode of presentation, need for pediatric intensive care unit (PICU) admission, the severity of illness at the time of PICU admission, and data related to outcomes. We analyzed the data using logistical regression with Firth’s biased reduction method wherever applicable. Results In our cohort, over 85% of the patients identified as belonging to Hispanic ethnicity (n=66); the median age of the cohort was 8.69 years, and 50.65% were classified as obese (n=39). We found a statistically significant relationship between underlying obesity and one or more comorbidities (p<0.001). BMI classification was significantly dependent on the incidence of multisystem inflammatory syndrome in children (MIS-C) (p=0.0353). Furthermore, the bivariate analysis confirmed that acute kidney injury (AKI) (p=0.048) and MIS-C predictors (p<0.001) were significantly associated with PICU admission status. The combined model confirmed a significant relationship between MIS-C and both PICU admission status (p<0.001) and obese BMI classification (p=0.002). PICU admission status led to increased hospital length of stay (LOS) (p<0.001). Patient age (p=0.003), underweight BMI (p=0.034), and obese BMI (P=0.008) were significant predictors of PICU LOS. Of note, the survival rate among admitted COVID-19 patients was 93.5%. Conclusion Based on our findings on the prevalence of underlying obesity in admitted COVID-19 patients at the Children’s Hospital of San Antonio, over 50% of pediatric patients were obese and predominately Hispanic. Obesity was significantly associated with patient age, comorbidities, MIS-C status, and PICU LOS. Hospital mortality in pediatric COVID-19 patients was low (6.49%) and consistent with other studies in the literature showing lower rates of mortality in children versus mortality in adult patients with COVID-19.
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16
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Lee M, Hwang JY, Park SE, Jung S, Jo KJ. A Case Report of Postinfectious Bronchiolitis Obliterans After Coronavirus Disease 2019 in a 10-Year-Old Child. J Korean Med Sci 2022; 37:e246. [PMID: 35942559 PMCID: PMC9359921 DOI: 10.3346/jkms.2022.37.e246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/19/2022] [Indexed: 11/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is usually less severe in children and adolescents than in adults. However, it can cause severe respiratory illness in a small proportion of children with risk factors. Here, we report a rare case of a 10-year-old boy with postinfectious bronchiolitis obliterans that developed after pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This patient was previously healthy apart from a high body mass index (BMI, 30.13; 99.6th percentile for the age bracket), history of preterm birth (35 weeks), and low birth weight (1,850 g). He had persistent exertional dyspnea after recovering from SARS-CoV-2-related pneumonia. Spirometry revealed obstructive lung disease with the following results: predicted forced vital capacity (FVC%pred), 71%; forced expiratory volume in 1 second (FEV1%pred), 63%; FEV1/FVC, 0.81; and forced expiratory flow25-75%pred, 55%. Chest computed tomography showed multifocal areas of parenchymal hyperlucency and mosaic attenuation in both lungs. This case suggests that careful observation of children with obesity and low birth weight is necessary after recovery from SARS-CoV-2-related pneumonia.
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Affiliation(s)
- Miran Lee
- Department of Pediatrics, Division of Pediatric Allergy and Respiratory Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Su Eun Park
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Sungsu Jung
- Department of Pediatrics, Division of Pediatric Allergy and Respiratory Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea.
| | - Kyo Jin Jo
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea.
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17
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Halvorson EE, Saha A, Forrest CB, Razzaghi H, Brittan M, Christakis DA, Cole FS, Mejias A, Phan TLT, McCrory MC, Wells BJ, Skelton JA, Poehling KA, Tieder JS. Associations Between Weight and Lower Respiratory Tract Disease Outcomes in Hospitalized Children. Hosp Pediatr 2022; 12:734-743. [PMID: 35822402 DOI: 10.1542/hpeds.2021-006404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To identify associations between weight status and clinical outcomes in children with lower respiratory tract infection (LRTI) or asthma requiring hospitalization. METHODS We performed a retrospective cohort study of 2 to 17 year old children hospitalized for LRTI and/or asthma from 2009 to 2019 using electronic health record data from the PEDSnet clinical research network. Children <2 years, those with medical complexity, and those without a calculable BMI were excluded. Children were classified as having underweight, normal weight, overweight, or class 1, 2, or 3 obesity based on Body Mass Index percentile for age and sex. Primary outcomes were need for positive pressure respiratory support and ICU admission. Subgroup analyses were performed for children with a primary diagnosis of asthma. Outcomes were modeled with mixed-effects multivariable logistic regression incorporating age, sex, and payer as fixed effects. RESULTS We identified 65 132 hospitalizations; 6.7% with underweight, 57.8% normal weight, 14.6% overweight, 13.2% class 1 obesity, 5.0% class 2 obesity, and 2.8% class 3 obesity. Overweight and obesity were associated with positive pressure respiratory support (class 3 obesity versus normal weight odds ratio [OR] 1.62 [1.38-1.89]) and ICU admission (class 3 obesity versus normal weight OR 1.26 [1.12-1.42]), with significant associations for all categories of overweight and obesity. Underweight was also associated with positive pressure respiratory support (OR 1.39 [1.24-1.56]) and ICU admission (1.40 [1.30-1.52]). CONCLUSIONS Both underweight and overweight or obesity are associated with increased severity of LRTI or asthma in hospitalized children.
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Affiliation(s)
| | | | - Christopher B Forrest
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Hanieh Razzaghi
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Mark Brittan
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado
| | - Dimitri A Christakis
- Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
| | - F Sessions Cole
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri
| | - Asuncion Mejias
- Division of Infectious Diseases, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
| | - Thao-Ly Tam Phan
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware
| | | | | | - Joseph A Skelton
- Departments of Pediatrics.,Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Katherine A Poehling
- Departments of Pediatrics.,Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Joel S Tieder
- Department of Pediatrics, University of Washington and Seattle Children's Hospital, Seattle, Washington
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18
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Sanchez-Piedra C, Gamiño-Arroyo AE, Cruz-Cruz C, Prado-Galbarro FJ. Impact of environmental and individual factors on COVID-19 mortality in children and adolescents in Mexico: An observational study. THE LANCET REGIONAL HEALTH - AMERICAS 2022; 8:100184. [PMID: 35079726 PMCID: PMC8775388 DOI: 10.1016/j.lana.2022.100184] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background During the Covid-19 pandemic, children and adolescents faced poverty, potentially dying from preventable causes, or missing out essential vaccines. The aim of this study was to assess potential environmental and individual factors associated to COVID-19 mortality in children and adolescents in Mexico. Methods This cross-sectional study analysed the official data of 131,001 children under 10 years of age and adolescents between 10 and 19 years of age with COVID-19 disease, in Mexico. Participants were diagnosticated between March 2020 and June 13, 2021. The environmental variables such as malnutrition, vaccination coverage and social lag index were evaluated at the state level. Multilevel models were fitted to evaluate the association between environmental and individual factors and COVID-19 mortality. Findings A total of 773 (0.6%) children and adolescents died due to COVID-19. Younger age (OR = 0.878, 95%CI: 0.869-0.888), diabetes (OR = 3.898, 95%CI: 2.596-5.851), immunosuppression (OR = 5.410, 95%CI: 4.088-7.158), obesity (OR = 1.876, 95%CI: 1.397-2.521), hypertension (OR = 1.906, 95%CI: 1.239-2.932), cardiovascular disease (OR = 2.288, 95%CI: 1.482-3.531), and chronic kidney disease (OR = 13.250, 95%CI: 9.066-19.350) were associated with mortality. COVID-19 mortality was directly associated with social lag index and malnutrition (ORvery high = 2.939, 95%CI: 1.111-7.775, and OR = 1.390, 95%CI: 1.073-1.802, respectively), and inversely associated with population density (OR = 0.374, 95%CI: 0.204-0.688). Finally, children and adolescents living in areas with a higher percentage of people with incomplete education (OR = 1.045, 95%CI: 1.011-1.081), of children of school age of 6–14 years who do not attend school (OR = 1.266, 95%CI: 1.032-1.554), and of illiterate population aged 15 and over (OR = 1.086, 95%CI: 0.999-1.179) were associated with a higher risk of COVID-19 mortality. Interpretation Malnutrition, social lag index and population density are key factors to understand COVID-19 mortality in children and adolescents. Also, age and pre-existing comorbidities were also associated with worse COVID-19 prognosis. Funding No funding was secured for this study.
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Affiliation(s)
| | | | - Copytzy Cruz-Cruz
- Orphan Drug Laboratory, Biologic System Department, Metropolitan Autonomous University-Campus Xochimilco, Calzada del Hueso 1100, Coapa, Villaquietud, Coyoacán, Mexico City 04960, Mexico
| | - Francisco-Javier Prado-Galbarro
- Orphan Drug Laboratory, Biologic System Department, Metropolitan Autonomous University-Campus Xochimilco, Calzada del Hueso 1100, Coapa, Villaquietud, Coyoacán, Mexico City 04960, Mexico
- Corresponding author.
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19
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How Comorbidities Affect Hospitalization from Influenza in the Pediatric Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052811. [PMID: 35270503 PMCID: PMC8910429 DOI: 10.3390/ijerph19052811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023]
Abstract
Influenza is a contagious respiratory illness and can lead to hospitalization and even death. Understanding how comorbidities affect the severity of influenza can help clinical management. The aim of this study is to offer more information about comorbidities that might be associated with the severity of influenza in children. We used a statewide network in Rhode Island, USA, to extract data for laboratory-confirmed influenza cases among children 19 years old or younger. We identified 1169 lab-confirmed influenza cases. The most common comorbidities were asthma (17.1%), neurodevelopmental disorders (10.3%), gastrointestinal disorders (7.6%), atopic dermatitis (7%), and endocrine and metabolic diseases (6.8%). Interestingly, 80.8% (63 out of 78) of children who had an influenza-related hospital admission had at least one comorbidity, and among hospitalized children with influenza, the most common comorbidities were neurological diseases (28.2%, 22/78), gastrointestinal disorders (25.6%, 20/78), endocrine and metabolic diseases (24.4%, 19/78), and neurodevelopmental disorders (23.1%, 18/78). Children with endocrine or metabolic diseases were 8.23 times more likely to be admitted to the hospital, and children with neurological disorders were 6.35 times more likely to be admitted (OR: 8.23, 95% CI: 4.42–15.32 and OR: 6.35, 95% CI: 3.60–11.24, respectively). In summary, we identified specific comorbidities associated with influenza hospitalization and length of hospital stay, and these groups should be prioritized for public health interventions.
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Yu P, Tan Z, Li Z, Xu Y, Zhang J, Xia P, Tang X, Ma J, Xu M, Liu X, Shen Y. Obesity and clinical outcomes in COVID-19 patients without comorbidities, a post-hoc analysis from ORCHID trial. Front Endocrinol (Lausanne) 2022; 13:936976. [PMID: 35966085 PMCID: PMC9372447 DOI: 10.3389/fendo.2022.936976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/30/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Large body of studies described individuals with obesity experiencing a worse prognosis in COVID-19. However, the effects of obesity on the prognosis of COVID-19 in patients without comorbidities have not been studied. Therefore, the current study aimed to provide evidence of the relationship between obesity and clinical outcomes in COVID-19 patients without comorbidities. METHODS A total of 116 hospitalized COVID-19 patients without comorbidities from the ORCHID study (Patients with COVID-19 from the Outcomes Related to COVID-19 Treated with Hydroxychloroquine among Inpatients with Symptomatic Disease) were included. Obesity is defined as a BMI of ≥30 kg/m2. A Cox regression analysis was used to estimate the hazard ratio (HR) for discharge and death after 28 days. RESULTS The percentage of obesity in COVID-19 patients without comorbidities was 54.3% (63/116). Discharge at 28 days occurred in 56/63 (84.2%) obese and 51/53 (92.2%) non-obese COVID-19 patients without comorbidities. Four (3.4%) COVID-19 patients without any comorbidities died within 28 days, among whom 2/63 (3.2%) were obese and 2/53 (3.8%) were non-obese. Multivariate Cox regression analyses showed that obesity was independently associated with a decreased rate of 28-day discharge (adjusted HR: 0.55, 95% CI: 0.35-0.83) but was not significantly associated with 28-day death (adjusted HR: 0.94, 95% CI: 0.18-7.06) in COVID-19 patients without any comorbidities. CONCLUSIONS Obesity was independently linked to prolonged hospital length of stay in COVID-19 without any comorbidity. Larger prospective trials are required to assess the role of obesity in COVID-19 related deaths.
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Affiliation(s)
- Peng Yu
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, China
| | - Ziqi Tan
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhangwang Li
- The Second Clinical Medical College of Nanchang University, Nanchang, China
| | - Yi Xu
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jing Zhang
- The Second Clinical Medical College of Nanchang University, Nanchang, China
| | - Panpan Xia
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, China
| | - Xiaoyi Tang
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Minxuan Xu
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, China
| | - Xiao Liu
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, China
- *Correspondence: Yunfeng Shen, ; Xiao Liu,
| | - Yunfeng Shen
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, China
- *Correspondence: Yunfeng Shen, ; Xiao Liu,
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21
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Shoji K, Akiyama T, Tsuzuki S, Matsunaga N, Asai Y, Suzuki S, Iwamoto N, Funaki T, Ohmagari N. Comparison of the clinical characteristics and outcomes of COVID-19 in children before and after the emergence of Delta variant of concern in Japan. J Infect Chemother 2022; 28:591-594. [PMID: 35074258 PMCID: PMC8769918 DOI: 10.1016/j.jiac.2022.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 11/26/2022]
Abstract
Delta variant of concern (VOC) is the current predominant severe acute respiratory coronavirus type 2 strain causing coronavirus disease 2019 (COVID-19); however, information regarding the impact of the Delta VOC on clinical features and outcomes in pediatric patients with COVID-19 is limited. We conducted a retrospective observational study using the data of patients <18 years of age in COVIREGI-JP, the COVID-19 registry in Japan. The patients were divided into two groups according to the timing of enrollment in the registry (pre-Delta VOC era, October 2020 to May 2021; and Delta VOC era, August to October 2021), and the clinical characteristics and outcomes were compared between the two groups. During the study period, 950 and 349 pediatric patients were registered in the pre-Delta VOC and Delta VOC eras, respectively. The median patient age was younger and the proportion of patients with underlying diseases was higher in the Delta VOC era than that in the pre-Delta VOC era (10.0 vs 7.0 years, P < 0.001, and 7.4% [n = 70] vs. 12.6% [n = 44], P = 0.004, respectively). Significantly more patients were admitted to the intensive care unit in the Delta VOC era than in the pre-Delta VOC era (1.4% [ n = 5] vs. 0.1% [n = 1], P = 0.006), but no patient in either group died or required mechanical ventilation or extracorporeal membrane oxygenation throughout the study period, suggesting that the overall outcomes in children with COVID-19 remained favorable even in the Delta VOC era in Japan.
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22
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Cena H, Fiechtner L, Vincenti A, Magenes VC, De Giuseppe R, Manuelli M, Zuccotti GV, Calcaterra V. COVID-19 Pandemic as Risk Factors for Excessive Weight Gain in Pediatrics: The Role of Changes in Nutrition Behavior. A Narrative Review. Nutrients 2021; 13:4255. [PMID: 34959805 PMCID: PMC8707175 DOI: 10.3390/nu13124255] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/17/2022] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, social isolation, semi-lockdown, and "stay at home" orders were imposed upon the population in the interest of infection control. This dramatically changes the daily routine of children and adolescents, with a large impact on lifestyle and wellbeing. Children with obesity have been shown to be at a higher risk of negative lifestyle changes and weight gain during lockdown. Obesity and COVID-19 negatively affect children and adolescents' wellbeing, with adverse effects on psychophysical health, due in large part to food choices, snacking between meals, and comfort eating. Moreover, a markable decrease in physical activity levels and an increase in sedentary behavior is associated with weight gain, especially in children with excessive weight. In addition, obesity is the most common comorbidity in severe cases of COVID-19, suggesting that immune dysregulation, metabolic unbalance, inadequate nutritional status, and dysbiosis are key factors in the complex mechanistic and clinical interplay between obesity and COVID-19. This narrative review aims to describe the most up-to-date evidence on the clinical characteristics of COVID-19 in children and adolescents, focusing on the role of excessive weight and weight gain in pediatrics. The COVID-19 pandemic has taught us that nutrition education interventions, access to healthy food, as well as family nutrition counselling should be covered by pediatric services to prevent obesity, which worsens disease outcomes related to COVID-19 infection.
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Affiliation(s)
- Hellas Cena
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; (H.C.); or (M.M.)
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | - Lauren Fiechtner
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA 02114, USA;
- Division of Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Boston, MA 02114, USA
- Center for Pediatric Nutrition, Harvard Medical School, Boston, MA 02115, USA
| | - Alessandra Vincenti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | | | - Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.V.); (R.D.G.)
| | - Matteo Manuelli
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100 Pavia, Italy; (H.C.); or (M.M.)
| | - Gian Vincenzo Zuccotti
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (G.V.Z.)
- “L. Sacco” Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (V.C.M.); (G.V.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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23
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Rubenstein S, Grew E, Clouser K, Kwok A, Veerapandiyan A, Kornitzer J, Pecor K, Ming X. COVID-19 in Pediatric Inpatients: A Multi-Center Observational Study of Factors Associated with Negative Short-Term Outcomes. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8110951. [PMID: 34828664 PMCID: PMC8620202 DOI: 10.3390/children8110951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 04/23/2023]
Abstract
Most cases of COVID-19 in children and adolescents are mild or asymptomatic, but a small number of individuals may develop severe disease, requiring PICU admission and/or mechanical ventilation. We assessed the factors associated with negative short-term outcomes of COVID-19 in 82 pediatric patients at three hospitals within the United States during the spring and summer of 2020 using medical records, laboratory data, and imaging studies of all patients admitted with a positive RT-PCR test for SARS-CoV-2. We found that older patients were more likely to have an extended hospital stay, and those with high BMIs (over 25) were more likely to be admitted to the PICU during the early pandemic. In addition, older patients, those with high BMIs, and those with underlying medical conditions, were more likely to receive respiratory support. Given the association of age, BMI, and underlying medical conditions with more severe COVID-19, clinicians should keep these factors in mind when treating patients.
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Affiliation(s)
- Sara Rubenstein
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
| | - Emily Grew
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
| | - Katharine Clouser
- Pediatric Hospital Medicine, Hackensack University Medical Center, Hackensack, NJ 07601, USA;
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Alexander Kwok
- Division of Pediatric Neurology, University of Arkansas for Medical Sciences, Little Rock, AR 72005, USA; (A.K.); (A.V.)
| | - Aravindhan Veerapandiyan
- Division of Pediatric Neurology, University of Arkansas for Medical Sciences, Little Rock, AR 72005, USA; (A.K.); (A.V.)
| | - Jeffrey Kornitzer
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
- Division of Neurology, New Jersey Pediatric Neuroscience Institute, Morristown, NJ 07960, USA
- Division of Child Neurology, St. Joseph’s Children’s Hospital, Paterson, NJ 07503, USA
| | - Keith Pecor
- Department of Biology, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Xue Ming
- Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA; (S.R.); (E.G.); (J.K.)
- Correspondence:
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