@article{3b34239d79ab4f9988f47f72de085ab8,
title = "The Impact of Obesity on Disease Severity and Outcomes Among Hospitalized Children With COVID-19",
abstract = "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.",
author = "{Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group} and Sandeep Tripathi and Christison, {Amy L.} and Emily Levy and Jeremy McGravery and Aysun Tekin and Dawn Bolliger and Kumar, {Vishakha K.} and Vikas Bansal and Kathleen Chiotos and Gist, {Katja M.} and Dapul, {Heda R.} and Bhalala, {Utpal S.} and Gharpure, {Varsha P.} and Heneghan, {Julia A.} and Neha Gupta and Bjornstad, {Erica C.} and Montgomery, {Vicki L.} and Allan Walkey and Rahul Kashyap and Arteaga, {Grace M.} and Tanja Kovacevic and Josko Markic and Ardalic, {Tatjana Catipovic} and Branka Polic and Ivo Ivi{\'c} and Dominko Carev and Robert Glavinic and Umamaheswara Raju and Janaki Manduva and Naresh Kolakani and Shreeja Sripathi and Sheetal Chaitanya and Mohan, {Surapaneni Krishna} and Ekambaram Jyothisree and Sidra Ishaque and Saleem, {Ali Faisal} and Siddiqui, {Naveed Ur Rehman} and Salima Sherali and Yasmin Hashwani and Shafia Ishaque and Asghar, {Muhammad Sohaib} and Mashaal Syed and Naqvi, {Syed Anosh Ali} and Almazyad, {Mohammed A.} and Alarifi, {Mohammed I.} and Macarambon, {Jara M.} and Bukhari, {Ahmad Abdullah} and Albahrani, {Hussain A.} and Asfina, {Kazi N.} and Aldossary, {Kaltham M.} and Usman Raheemi and Suzanne Barry and Christopher Woll and Gregory Wu and Erin Carrole and Kathryn Burke and Mustafa Mohammed and {St Hill}, {Catherine A.} and Melamed, {Roman R.} and Tierney, {David M.} and Patel, {Love A.} and Raj, {Vino S.} and Dawud, {Barite U.} and Narayana Mazumder and Abbey Sidebottom and Guenther, {Alena M.} and Krehbiel, {Benjamin D.} and Schmitz, {Nova J.} and Jepsen, {Stacy L.} and Katherine Irby and Sanders, {Ronald C.} and Glenda Hefley and Mosier, {Jarrod M.} and Karen Lutrick and Campbell, {Beth Salvagio} and Cathleen Wilson and Patrick Rivers and Jonathan Brinks and Mongoh, {Mokenge Ndiva} and Boris Gilson and Danesh, {Valerie C.} and Gueorgui Dubrocq and Davis, {Amber L.} and Hammers, {Marissa J.} and McGahey, {Ill M.} and Farris, {Amanda C.} and Elisa Priest and Robyn Korsmo and Lorie Fares and Kathy Skiles and Shor, {Susan M.} and Kenya Burns and Dowell, {Corrie A.} and Gabriela Gonzales and Melody Flores and Lindsay Newman and Wilk, {Debora A.} and Jason Ettlinger and Jaccallene Bomar and Himani Darji and Alejandro Arroliga and Arroliga, {Alejandro C.} and Dowell, {Corrie A.} and Conzales, {Gabriela Hope} and Melody Flores and Lindsay Newman and Wilk, {Debora A.} and Jason Ettlinger and Himani Darji and Jaccallene Bomar and Khandhar, {Paras B.} and Elizabeth Kring and Miller, {Aaron S.} and Anderson, {Edwin L.} and Rosemary Nagy and Inja, {Ravali R.} and Mayank Sharma and Neha Deo and Shahraz Qamar and Romil Singh and Marija Bogojevic and Blatz, {Allison M.} and Giyoung Lee and Burnett, {Ryan H.} and Sydney, {Guy I.} and Traynor, {Danielle M.} and Margit Kaufman and Gregg Lobel and Nisha Gandhi and Amr Abdelaty and Elizabeth Shaji and Kiana Lim and Juan Marte and Sosa, {Dani Ashley} and Heavner-Sullivan, {Smith F.} and Roth, {Prera J.} and Banu Sivaraj and Haley Fulton and Herin, {Madison G.} and Marissa Crum and Fretwell, {Morgan E.} and Zhou, {Emily Rose} and Sourabh Verma and Alan Salas and Ariel Daube and Michelle Korn and Michelle Ramirez and Logi Rajagopalan and Laura Santos and Bercow, {Asher G.} and Mark Shlomovich and Steuernagle, {J. H.} and Melissa Thomas and Sarah Morris and Jennifer Nason and Gupta, {Manoj K.} and Oulds, {Franscene E.} and Akshay Nandavar and Wen, {Andy Y.} and Allie DaCar and Reilkoff, {Ronald A.} and Sarah Eichen and Lexie Goertzen and Scott Rajala and Ghislaine Feussom and Ben Tang and Christie, {Amy B.} and Ashley, {Dennis W.} and Rajani Adiga and Prithvi Sendi and Meghana Nadiger and Balagangadhar Totapally and Aulakh, {Bhagat S.} and Bandy, {Jennifer A.} and Kreps, {Lisa M.} and Bollinger, {Dawn R.} and Bandy, {Jennifer A.} and Shina Menon and McGuire, {John K.} and Deana Rich and Anderson, {Harry L.} and Dixy Rajkumar and Ali Abunayla and Jerrilyn Heiter and Zaren, {Howard A.} and Smith, {Stephanie J.} and Lewis, {Grant C.} and Lauren Seames and Cheryl Farlow and Judy Miller and Gloria Broadstreet and John Lin and Cindy Terrill and Brock Montgomery and Sydney Reyes and Summer Reyes and Alex Plattner and Anthony Martinez and Micheal Allison and Aniket Mittal",
note = "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 {\textcopyright} 2021 by the American Academy of Pediatrics.",
year = "2021",
month = nov,
day = "1",
doi = "10.1542/hpeds.2021-006087",
language = "English",
volume = "11",
pages = "E297--E307",
journal = "Hospital Pediatrics",
issn = "2154-1663",
number = "11",
}