Risk of post-COVID symptoms linked to body mass index in children

A study by the University of Pennsylvania and researchers from 26 US children’s hospitals has associated increased body mass index (BMI) with a significantly higher risk of developing post-acute sequelae of SARS-CoV-2 infection (PASC) in children and young adults.

The study revealed a 25.4% increased risk of PASC in people with obesity and a 42.1% increased risk in people with severe obesity compared to peers with a healthy BMI.

PASC includes a wide range of persistent, recurrent, or newly emerging symptoms that persist for more than four weeks after the acute phase of COVID-19. According to the NIH, the most common signs and symptoms are fatigue, shortness of breath, muscle aches, joint pain, headache, cough, chest pain, altered smell, altered taste and diarrhea.

The study additionally identifies many more symptoms such as abdominal pain, abnormal liver enzyme levels, acute kidney injury, acute respiratory distress syndrome, arrhythmias, cognitive impairment, fever and chills, fluid and electrolyte imbalance, generalized pain, hair loss, heart disease, etc. mental disorders, myocarditis , myositis, postural orthostatic tachycardia syndrome (POTS) or dysautonomia, skin symptoms, thrombophlebitis and thromboembolism.

Although obesity is known to be associated with increased severity of COVID-19, its relationship with PASC in pediatric populations is unclear.

In one retrospective cohort study“Body Mass Index and post-acute sequelae of SARS-CoV-2 infection in children and young adults,” published in JAMA network openedthe researchers looked for trends related to body mass in PASC.

The team analyzed data from 172,136 participants aged 5 to 20 years with documented SARS-CoV-2 infection between March 2020 and May 2023. Participants were categorized based on their BMI status prior to infection: healthy weight, overweight, obese and severe obesity.

The results showed that, compared to healthy weight participants, those with obesity had a 25.4% increased risk of PASC. Those with severe obesity had an increased risk of 42.1% when identified using the diagnostic code for post-COVID-19 conditions. An increased risk of developing PASC symptoms and conditions was also observed in obese and severely obese people.

The researchers concluded that increased BMI is associated with significantly increased PASC risk in a dose-dependent manner, highlighting the need for targeted care to prevent chronic conditions in at-risk children and young adults.

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