Division of Pediatric Nephrology, Hospital das Clínicas, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Department of Pediatrics, Health Sciences Postgraduate Program, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Pediatr Obes. 2022 Sep;17(9):e12920. doi: 10.1111/ijpo.12920. Epub 2022 Apr 28.
Obesity is a well-recognized risk factor for critical illness and death among adult patients with SARS-CoV-2 infection.
This study aimed to characterize the clinical outcomes and risk factors of death related to obesity in a cohort of hospitalized paediatric patients with COVID-19.
We performed an analysis of all paediatric patients with obesity and COVID-19 registered in SIVEP-Gripe, a Brazilian nationwide surveillance database, between February 2020 and May 2021. The primary outcome was time to death, which was evaluated by using cumulative incidence function.
Among 21 591 hospitalized paediatric patients with COVID-19, 477 cases (2.2%) had obesity. Of them, 71 (14.9%) had a fatal outcome as compared with 7.5% for patients without obesity (hazard ratio [HR] = 2.0, 95% confidence interval [CI] 1.59-2.53, p < 0.001). After adjustment, the factors associated with death among patients with obesity were female gender (HR = 2.8, 95% CI 1.70-4.61), oxygen saturation < 95% (HR = 2.58, 95% CI 1.38-4.79), presence of one (HR = 1.91, 95% CI 1.11-3.26), and two or more comorbidities (HR = 4.0, 95% CI 2.21-7.56).
Children and adolescents with obesity had higher risk of death compared with those without obesity. The higher risk of death was associated with female gender, low oxygen saturation at admission, and presence of other comorbidities.
肥胖是 SARS-CoV-2 感染成年患者发生重症和死亡的公认危险因素。
本研究旨在描述肥胖与 COVID-19 住院患儿临床结局和死亡相关的风险因素。
我们对 2020 年 2 月至 2021 年 5 月间在巴西全国监测数据库 SIVEP-Gripe 登记的所有肥胖 COVID-19 患儿进行了分析。主要结局是死亡时间，采用累积发生率函数进行评估。
在 21591 例 COVID-19 住院患儿中，477 例（2.2%）患有肥胖症。其中，71 例（14.9%）死亡，而无肥胖症患儿的死亡率为 7.5%（风险比 [HR] 2.0，95%置信区间 [CI] 1.59-2.53，p < 0.001）。调整后，肥胖患儿死亡的相关因素为女性（HR 2.8，95%CI 1.70-4.61）、氧饱和度<95%（HR 2.58，95%CI 1.38-4.79）、存在 1 种（HR 1.91，95%CI 1.11-3.26）或 2 种以上合并症（HR 4.0，95%CI 2.21-7.56）。
与无肥胖症患儿相比，肥胖儿童和青少年死亡风险更高。死亡风险较高与女性、入院时氧饱和度低和存在其他合并症有关。
