The Association Between Obesity and COVID-19 Severity in Children Differed Between SARS-CoV-2 Variants: A...

Area of Science:

• Pediatric Infectious Diseases
• Epidemiology
• Public Health

Background:

• Obesity posed a significant risk for severe COVID-19 in children during the ancestral and Delta variant waves.
• The impact of obesity on pediatric COVID-19 severity during the Omicron variant surge remained undetermined.

Purpose of the Study:

• To investigate the association between childhood obesity and COVID-19 severity during different SARS-CoV-2 variant waves.
• To determine if vaccination status influenced the relationship between obesity and respiratory support needs.

Main Methods:

• A multicenter, observational study analyzed hospitalized children and adolescents with confirmed SARS-CoV-2 infection.
• Data spanned three periods: ancestral strain (T1), pre-Omicron variants (T2), and Omicron (T3).
• The primary outcome measured was the requirement for respiratory support (supplemental oxygen or ventilation).

Main Results:

• Obesity was linked to increased respiratory support needs during T1 (RR 3.45) and T2 (RR 3.24).
• This association was not significant during the Omicron wave (T3) (RR 3.08).
• Findings persisted in unvaccinated children, suggesting vaccination did not explain the diminished association.

Conclusions:

• Childhood obesity was a risk factor for severe COVID-19 during ancestral and pre-Omicron waves.
• The association between obesity and severe COVID-19 was lost during the Omicron wave.
• This shift highlights evolving SARS-CoV-2 variant impacts on pediatric populations, irrespective of vaccination status.