NYU Langone Comprehensive Program on Obesity, NYU Grossman School of Medicine, New York, New York, USA.
Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA.
Pediatr Obes. 2022 Mar;17(3):e12856. doi: 10.1111/ijpo.12856. Epub 2021 Sep 27.
Limited research has addressed the obesity-COVID-19 severity association in paediatric patients.
To determine whether obesity is an independent risk factor for COVID-19 severity in paediatric patients and whether age modifies this association.
SARS-CoV-2-positive patients at NYU Langone Health from 1 March 2020 to 3 January 2021 aged 0-21 years with available anthropometric measurements: weight, length/height and/or body mass index (BMI). Modified log-Poisson models were utilized for the analysis. Main outcomes were 1) hospitalization and 2) critical illness (intensive care unit [ICU] admission).
One hundred and fifteen of four hundred and ninety-four (23.3%) patients had obesity. Obesity was an independent risk factor for critical illness (adjusted risk ratio [ARR] 2.02, 95% CI 1.17 to 3.48). This association was modified by age, with obesity related to a greater risk for critical illness in adolescents (13-21 years) [ARR 3.09, 95% CI 1.48 to 6.47], but not in children (0-12 years). Obesity was not an independent risk factor for hospitalization for any age.
Obesity was an independent risk factor for critical illness in paediatric patients, and this association was modified by age, with obesity related to a greater risk for critical illness in adolescents, but not in children. These findings are crucial for patient risk stratification and care.
针对肥胖与儿科患者 COVID-19 严重程度的相关性，相关研究较少。
明确肥胖是否为儿科患者 COVID-19 严重程度的独立危险因素，以及年龄是否对此相关性具有修饰作用。
选取 2020 年 3 月 1 日至 2021 年 1 月 3 日期间于纽约大学朗格尼健康中心就诊的 SARS-CoV-2 阳性、年龄 0-21 岁且存在体重、身长/身高和/或体质量指数（BMI）等人体测量学指标的患儿。采用修正对数泊松模型进行分析。主要结局指标为 1）住院治疗和 2）重症（入住重症监护病房[ICU]）。
494 例患儿中，115 例（23.3%）存在肥胖。肥胖是重症的独立危险因素（校正风险比[ARR] 2.02，95%置信区间[CI] 1.17 至 3.48）。该相关性受年龄修饰，肥胖与青少年（13-21 岁）重症的相关性更大（ARR 3.09，95% CI 1.48 至 6.47），但与儿童（0-12 岁）无关。肥胖不是任何年龄段患儿住院的独立危险因素。
肥胖是儿科患者重症的独立危险因素，该相关性受年龄修饰，肥胖与青少年重症的相关性更大，与儿童无关。这些发现对于患者风险分层和治疗至关重要。
