Overweight, Obesity Linked with Increased Long COVID Risk in Pediatric Patients
Research has found that children and young adults with overweight or obesity may be at a significantly increased risk of developing long COVID.
Children and young adults with overweight or obesity may be at a significantly increased risk of developing long COVID, according to research published in JAMA Network Open.1 The authors of the study said the findings highlight the need for targeted care to prevent chronic conditions in at-risk pediatric patients.
Overweight, Obesity Linked with Increased Long COVID Risk in Pediatric Patients / Dzmitry - stock.adobe.com
According to data from the CDC, approximately 1 in 5 children and adolescents in the United States have obesity.2 Obesity in pediatric patients has been associated with negative physical and psychological health outcomes, including type 2 diabetes, cardiovascular disease, poor academic performance, and a lower quality of life.3 Previous research has found that obesity and overweight are risk factors for long COVID.4
READ MORE: COVID-19 Vaccines May Reduce Incidence of Long COVID Symptoms
“[Long COVID] continues to pose a substantial threat to children, necessitating an urgent and deeper understanding of pediatric [long COVID] causes,” the authors wrote. “This research priority is underscored in the updated National Institute for Health and Care Excellence guideline. This need to unravel the complexities of pediatric [long COVID] continues to be crucial even after the COVID-19 pandemic.”
A team of investigators from the University of Pennsylvania and the University of Pittsburgh conducted a study to examine if elevated body mass index (BMI) is linked with an increased risk of developing long COVID among children and young adults. Data for the study was gathered from electronic health records at 26 hospitals, primary care and outpatient settings from March 2020 to May 2023.
The study cohort included 172136 patients who had a documented infection with SARS-CoV-2 and were younger than 21 years of age. Patients were included in the study if they had at least 1 visit within the baseline period of 18 months to 7 days prior to the index date and had at least 1 visit within the follow-up period of 28 days to 179 days after the index date. Patients were not included if they were younger than 5 years and had any genetic syndromes that are associated with obesity or any conditions signaling a need for weight gain.
The study found that 1402 patients received a diagnosis of long COVID during the follow-up period, of which 751 had obesity or severe obesity. At least 1 incident occurrence of long COVID symptoms and conditions occurred in 63046 patients, of which 8792 had obesity or severe obesity. Although patients with overweight, obesity or severe obesity had a higher risk of long COVID, not all estimates reached statistical significance. There was a significant dose-response association of increasing BMI category with risk of long COVID.
The association between a higher BMI and increased risk of long COVID remained consistent despite adjusting for sociodemographic and clinical factors. However, subgroup analyses by race and ethnicity suggested a potential effect size modification, which the authors said warrants further investigation.
Study limitations include a lack of information on modifiable risk factors like diet and physical activity, the potential for overclassification in pediatric long COVID diagnosis due to a lack of standardized criteria, and the potential for selection bias due to the fact that children with a higher BMI are more likely to be hospitalized.
“Our study found a significant association of higher pre–COVID-19 BMI with increased [long COVID] risk in pediatric patients, highlighting the need for vigilant monitoring and personized care for those with elevated BMI,” the authors concluded. “This association underscores the importance of early identification and targeted interventions to prevent long-term consequences. Public health efforts should focus on raising awareness and promoting healthy lifestyle behaviors to reduce severe outcomes.”
READ MORE: COVID-19 Resource Center
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