Post Graduate Program in Pediatrics and Child Health of PUCRS - Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 - Partenon, Porto Alegre, 90619-900, RS, Brazil.
Pontifical Catholic University of Rio Grande do Sul, Av. Ipiranga, 6681 - Partenon, Porto Alegre, 90619-900 - RS, Brazil.
Clin Nutr ESPEN. 2022 Jun;49:114-120. doi: 10.1016/j.clnesp.2022.04.005. Epub 2022 Apr 9.
BACKGROUND & AIMS: Concomitantly to the coronavirus disease 2019 (COVID-19), in the child population there was already another pandemic wave in progress: childhood obesity. Numerous studies in adults have been carried out and describe obesity as an independent risk and prognostic factor for the severity of COVID-19. This study aims to systematically review the literature on the relation between weight excess and the severity of COVID-19 in children and adolescents.
This systematic review was developed following the PRISMA standards (Preferred Reporting Items for Systematic Review and Meta-Analysis). The literature search was performed in September 2020, in the following databases: MEDLINE (via PubMed), Embase, Scopus, The Cochrane Library (Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials (CENTRAL)), Web of Science, BVS/LILACS and SciELO. Registration on the PROSPERO platform (International Prospective Registry of Systematic Reviews) can be found under the registration number: CRD42021230686.
Of the 667 selected articles, 11 were included according to all agreed criteria, most of them being unicentric and American. In assessing the risk of bias and quality, following the criteria of the Newcastle-Ottawa Scale, eight studies achieved scores higher than 7. Only 5 studies sought to assess obesity and its relation with worse outcomes (such as need for pediatric intensive care unit (PICU), mechanical ventilation (MV), tracheostomy, hospital readmission and mortality), and out of these, only one article demonstrated this comorbidity as a prognostic factor for worse evolution of the COVID picture.
Few studies in the literature seek to assess excess weight and its relation with worse outcomes of COVID-19 in children and adolescents. Taking into account that there is already scientific evidence on this subject in adult patients, it is necessary to carry out more research in the pediatric age group.
继 2019 年冠状病毒病（COVID-19）之后，儿童人群中已经出现了另一场大流行浪潮：儿童肥胖症。大量针对成年人的研究已经开展，并描述肥胖是 COVID-19 严重程度的独立风险和预后因素。本研究旨在系统地回顾关于体重过重与儿童和青少年 COVID-19 严重程度之间关系的文献。
本系统评价按照 PRISMA 标准（系统评价和荟萃分析的首选报告项目）进行。文献检索于 2020 年 9 月在以下数据库中进行：MEDLINE（通过 PubMed）、Embase、Scopus、Cochrane 图书馆（Cochrane 系统评价数据库和 Cochrane 中央对照试验注册库（CENTRAL））、Web of Science、BVS/LILACS 和 SciELO。在 PROSPERO 平台（国际前瞻性系统评价注册）上的注册可在注册号：CRD42021230686 下找到。
在所选择的 667 篇文章中，根据所有商定的标准，有 11 篇被纳入，其中大多数为单中心和美国研究。根据纽卡斯尔-渥太华量表的标准评估偏倚和质量，有 8 项研究的评分高于 7 分。只有 5 项研究试图评估肥胖及其与更差结局（如需要儿科重症监护病房（PICU）、机械通气（MV）、气管切开术、住院再入院和死亡率）的关系，其中只有一篇文章证明这种合并症是 COVID 病情恶化的预后因素。
文献中很少有研究评估超重及其与儿童和青少年 COVID-19 更差结局的关系。考虑到在成年患者中已经有关于这个主题的科学证据，有必要在儿科年龄组中开展更多的研究。
