TABLE 2.
Short‐term complications and post‐acute sequela in paediatric inpatients with obesity and COVID‐19
| Outcomes | All patients (n = 216) | Patients with obesity (n = 67) | Patients without obesity (n = 149) | p value | Unadjusted OR (CI95%) or β coefficient (CI95%) |
|---|---|---|---|---|---|
| Short‐term: LOS, respiratory support, and organ support | |||||
| Hospital LOS, median (IQR), days | 7 (4–13.5) | 8 (6–21) | 6 (3–13) | 0.001 | 9.33 (−3.73–22.79) |
| ICU admission, n (%) | 91 (42.12) | 48 (71.64) | 43 (28.86) | <0.001 | 6.23 (3.15–12.48) |
| ICU LOS, median (IQR), days | 6 (4–18) | 6 (3.50–16.5) | 7 (4–18) | 0.593 | −11.37 (−29.60‐ ‐6.87) |
| Oxygen, n (%) | 104 (48.15) | 49 (73.13) | 55 (36.91) | <0.001 | 4.65 (2.37–9.32) |
| Oxygen duration, median (IQR), days | 6 (4–12.50) | 7 (5–23) | 5 (2–11) | 0.002 | 6.67 (−1.00–14.33) |
| HFNC, n (%) | 27 (12.50) | 11 (16.42) | 16 (10.74) | 0.243 | 1.63 (0.64–4.01) |
| HFNC duration, median (IQR), days | 2 (1–5) | 1 (0–5) | 2 (1–5) | 0.730 | 1.48 (−2.77–5.74) |
| NIMV, n (%) | 25 (11.57) | 20 (29.85) | 5 (3.36) | <0.001 | 12.26 (4.11–43.52) |
| NIMV duration, median (IQR), days | 4 (3–5) | 4 (3–4.5) | 4 (2–5) | 1.000 | −0.85 (−3.30–1.60) |
| IMV, n (%) | 31 (14.35) | 14 (20.90) | 17 (11.41) | 0.066 | 2.05 (0.87–4.76) |
| IMV duration, median (IQR), days | 13 (6–23) | 14.5 (6–19) | 11 (5–23) | 0.736 |
−4.44 (−21.46–12.59) |
| HFOV, n (%) | 3 (1.39) | 1 (1.49) | 2 (1.39) | 0.930 | 1.11 (0.02–21.63) |
| ECLS, n (%) | 3 (1.39) | 3 (4.48) | 0 (0) | 0.029 | NA |
| Inotropes and vasoactive use, n (%) | 22 (10.19) | 9 (13.43) | 13 (8.72) | 0.290 | 1.62 (0.58–4.36) |
| iNO use, n (%) | 4 (1.85) | 2 (2.99) | 2 (1.34) | 0.407 | 2.26 (0.16–31.69) |
| Short‐term: superinfections | |||||
| Overall superinfections a , n (%) | 58 (26.85) | 29 (43.28) | 29 (19.46) | <0.001 | 3.16 (1.60–6.22) |
| Suspected bacterial pneumonia, n (%) | 50 (23.15) | 27 (40.30) | 23 (15.44) | <0.001 | 3.70 (1.81–7.54) |
| Overall proven superinfections, n (%) | 29 (13.43) | 13 (19.40) | 16 (10.74) | 0.084 | 2.00 (0.82–4.77) |
| Bacterial proven superinfections, n (%) | 25 (11.57) | 13 (19.40) | 12 (8.05) | 0.016 | 2.75 (1.08–7.02) |
| Viral proven superinfections, n (%) | 6 (2.78) | 2 (2.99) | 4 (2.68) | 0.601 | 1.12 (0.10–8.00) |
| Fungal proven superinfections, n (%) | 8 (3.70) | 3 (4.48) | 5 (3.36) | 0.706 | 1.35 (0.20–7.17) |
| Short‐term: medical complications | |||||
| MIS‐C, n (%) | 6 (2.78) | 3 (4.48) | 3 (2.01) | 0.308 | 2.28 (0.3–17.42) |
| AKI, n (%) | 30 (13.89) | 14 (20.9) | 16 (10.74) | 0.046 | 2.20 (0.92–5.16) |
| Thrombosis, n (%) | 8 (3.70) | 5 (7.46) | 3 (2.01) | 0.111 | 3.92 (0.73–25.86) |
| In‐hospital mortality, n (%) | 7 (3.24) | 0 (0) | 7 (4.70) | 0.071 | NA |
| Post‐acute sequelae b | |||||
| Tracheostomy, n (%) | 8 (3.70) | 5 (7.46) | 3 (2.01) | 0.111 | 3.92 (0.73–25.86) |
| Dyspnea, n (%) | 12 (5.74) | 10 (14.93) | 2 (1.41) | <0.001 | 12.28 (2.47–117.20) |
| Muscle weakness, n (%) | 15 (7.18) | 14 (20.90) | 1 (0.70) | <0.001 | 35.25 (5.33–1585.31) |
| Palpitations, n (%) | 5 (2.39) | 3 (4.48) | 2 (1.41) | 0.189 | 3.28 (0.36–939.92) |
Note: For numerical predictor variables, the beta (β) coefficient represents the degree of change in the predicted value of the outcome variable for every 1‐unit of change in the predictor variable, if all the other predictor variables included in the model remain constant. For categorical predictor variables, Odds Ratio (OR) value represents a measure of association between variables and obesity. Bold values denote statistical significance (p < 0.05).
Overall superinfections included patients with proven superinfections and/or suspected bacterial pneumonia.
For the included variables on Post‐Acute Sequelae of SARS CoV‐2 infection, patients who died during hospitalization for COVID‐19 (n = 7) were excluded. None of them were within the group of patients with obesity (n = 66), therefore 142 patients without obesity were analysed at follow‐up.
Abbreviations: AKI, acute kidney injury; CI95%, Confidence Interval of 95%; ECLS, Extracorporeal Life Support; HFNC, High Flow Nasal Cannula; HFOV, High Frequency Oscillatory Ventilation; ICU, Intensive Care Unit; IMV, Invasive Mechanical Ventilation; iNO, inhaled Nitric Oxide, IQR, Interquartile Range; LOS, Length Of Stay; MIS‐C, Multisystem Inflammatory Syndrome in Children; NA, not applicable; NIMV, Non‐Invasive Mechanical Ventilation; OR, Odds Ratio.