COVID-19 and obesity in children: clinical and diagnostic parallels

Abstract

Purpose: determination of the clinical course; laboratory and instrumental examination data; and analysis of the effectiveness of COVID-19 treatment in obese children.Materials and methods. 50 children with COVID-19 who were obese and 50 children with this infection who had a normal body weight were under observation. All patients underwent general clinical physical examination; laboratory studies (PCR analysis of smears from the mouth and nasopharynx for SARS-CoV-2 RNA; clinical and biochemical blood tests; general urine analysis; coagulogram; blood test for proteins of the acute  phase  of  inflammation);  instrumental  studies (pulsoximetry; CT of organs chest). In addition; weight; height and body mass index were determined for all children. Statistical processing of the obtained results was carried out using the nonparametric Mann-Whitney test and the parametric Student t-test for independent samples.Summary. 34% of obese patients had a history of other various background diseases. In this group; 76% of children had contact with acute respiratory infections in the family or organized groups. In both groups; all children had fever and intoxication; sore throat and rhinitis – in 24-36%; vomiting and diarrhea – in 10-12%. Significantly more often in obese patients; symptoms of respiratory tract damage such as cough (98% vs. 62%) and shortness of breath (36% vs. 2%) were observed. The duration of fever; intoxication; cough and shortness of breath in the group of obese patients was significantly higher compared to children in the comparison group. Obese patients had significantly higher CRP levels during hospitalization (18;6 vs. 8;4 mg/l); whereas by the time of discharge the differences had already been leveled (5;5 vs. 1;9 mg/l). In the observation group; the ferritin content was significantly higher relative to the comparison group both upon admission to the hospital (195;1 vs. 62;5 ng/ml) and after the end of the course of treatment (166;7 vs. 54;6 ng/ml). Lung damage according to CT studies in obese patients with COVID-19 was significantly more common than in the comparison group – 59;0±7;0% vs. 8;0±3;8%. They also developed grade I of respiratory failure more often; because the minimum SpO2 was lower than normal and lower relative to children with normal body weight (94;8±2;0% vs. 98;3±0;8%). Obese children required significantly longer treatment of COVID-19 relative to the comparison group for all types of therapy they received. As a result; these patients spent significantly more bed days in the hospital – 9;3±3;6 vs. 6;2±2;0.Conclusion. COVID-19 in obese children is more severe than in patients with normal body weight; which required long-term complex treatment in a hospital.