Children Sleeping

Paying Attention to Obesity and COVID-19 in Children

Faced with a threat, humans have remarkable skill for adapting. We learn about the threat. Then we figure out how to deal with it and prosper regardless. But maladaptive responses are also possible, such as denial and rationalization. For both COVID-19 and obesity, we see a bit of those at work. Arguments bubble up saying children are “essentially immune.” They account for a “tiny fraction of death.” Some folks even keep arguing falsely that obesity doesn’t influence outcomes in COVID-19. However, the truth is that we have good reasons to pay attention to obesity and COVID-19 in children.

A new study in CDC’s Morbidity and Mortality Weekly Reports on Friday adds to those reasons. Hospitalization rates are indeed lower for children with COVID-19 infections. But among children who wind up in the hospital with this infection, obesity is the most common pre-existing condition.

Three Published Reports

This report marks the third finding that obesity might be the most common pre-existing condition for children with COVID-19 who wind up in the hospital. This was an analysis of pediatric COVID-19 hospital data from 14 states.

Overall, the researchers confirmed that hospitalization is much less common for children than it is for adults. The rate is 8.0 per 100,000 children, compared to 164.5 per 100,000 adults. Much lower. Children do get COVID-19, but their symptoms are often either mild or even undetectable. So relatively few children wind up in the hospital.

Nevertheless, some do. From March 1 through July 25, these researchers found 576 children hospitalized with COVID-19. The median age was eight and 51 percent were males. Hospitalization rates were higher for Black and Hispanic children.

In the children for whom researchers had medical histories, 42 percent had underlying conditions. And by far, the most common underlying condition was obesity, which was present in 38 percent of these children. Lung disease was next, affecting 18 percent.

In June, researchers from a New York children’s hospital reported in JAMA Pediatrics that obesity was the most prevalent underlying condition in a series of 50 children admitted for COVID-19. In an earlier study in the Journal of Pediatrics, researchers also found that obesity was the most common underlying condition in 67 patients managed at a children’s hospital in New York.

Much to Learn

COVID-19 is very new. That means that we are learning a lot more about it virtually every day. But we already know that the immune response to this virus has a lot to do with how well or badly things unfold for any given patient. We also know that obesity – defined as unhealthy adiposity – has an effect on immune function.

We still have much to learn about obesity and COVID-19 in children. COVID-19 is a smaller problem for children than it is for adults, and especially older adults. But it’s not negligible. Coronavirus cases are rising in children, says the CDC. So it’s worth digging deeper to understand why we are seeing more obesity in children who have serious problems with COVID-19. Curiosity and objectivity are two of the best tools we have for solving a serious challenge like this.

Click here for the study in MMWR, here for the study in JAMA Pediatrics, and here for the study in the Journal of Pediatrics.

Children Sleeping, painting by Vasily Perov / WikiArt

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August 17, 2020