Pediatric Obesity—A Potential Risk Factor for Systemic Inflammatory Syndrome Associated to COVID-19, a Case Report

Mărginean, Cristina Oana; Meliţ, Lorena Elena; Săsăran, Maria Oana

doi:10.3389/fped.2021.681626

Cited by 10 publications

(21 citation statements)

References 29 publications

(39 reference statements)

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“… 60 , 61 Higher leptin levels have been demonstrated in SARS‐CoV‐2 ventilated patients and positively associated with high BMI. 62 During these past 2 years, several other inflammation biomarkers, including CRP, 26 , 27 , 28 , 29 , 31 , 32 , 35 , 37 , 40 , 41 , 44 , 63 innate receptors, 52 , 64 complement, 47 , 65 and lipidic mediators 47 have been associated with COVID‐19 severity in patients with obesity (Table 3 , Figures 2 and 3 ).…”

Section: Resultsmentioning

confidence: 99%

COVID‐19, obesity, and immune response 2 years after the pandemic: A timeline of scientific advances

et al. 2022

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Summary In the 2 years since the COVID‐19 pandemic was officially declared, science has made considerable strides in understanding the disease's pathophysiology, pharmacological treatments, immune response, and vaccination, but there is still much room for further advances, especially in comprehending its relationship with obesity. Science has not yet described the mechanisms that explain how obesity is directly associated with a poor prognosis. This paper gathers all published studies over the past 2 years that have described immune response, obesity, and COVID‐19, a historical and chronological record for researchers and the general public alike. In summary, these studies describe how the cytokine/adipokine levels and inflammatory markers, such as the C‐reactive protein, are associated with a higher body mass index in COVID‐19‐positive patients, suggesting that the inflammatory background and immune dysregulation in individuals with obesity may be expressed in the results and that adiposity may influence the immune response. The timeline presented here is a compilation of the results of 2 years of scientific inquiry, describing how the science has progressed, the principal findings, and the challenges ahead regarding SARS‐CoV‐2, COVID‐19, and emerging variants, especially in patients with obesity.

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Section: Resultsmentioning

confidence: 99%

COVID‐19, obesity, and immune response 2 years after the pandemic: A timeline of scientific advances

et al. 2022

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“…21 Among MIS-C cases, obesity was the most common comorbidity, consistent with the report of Hoste, et al 16 With obesity being associated with a chronic subclinical inflammatory status, it is hypothesized that COVID-19 infection triggers a greater hyperinflammatory response and higher endothelial, macrophage and adipocyte activation, leading to considerably elevated inflammatory markers and more severe complications. 22,23 Fever, cough, and colds were the predominant symptoms. However, gastrointestinal symptoms were also commonly reported, similar to those of Lu, et al 12 Inflammatory markers (CRP, procalcitonin and D-dimer) and markers for organ dysfunction (AST, ALT and LDH) were significantly higher in severe and critical disease compared to non-severe disease, similar to the study of Martin, et al 13 Radiographic findings were mostly normal, as reported in other studies.…”

Section: Resultsmentioning

confidence: 99%

SARS-CoV-2 Infection in Filipino Children: An Interim Report from the SALVACION Registry

Rivera¹,

Pantig²,

Maramba-Lazarte³

et al. 2022

PIDSPJ

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Background: The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. Methods: This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. Results: As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. Conclusion: Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.

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“…Although without statistical significance, our study also indicated the male gender to be more frequently diagnosed with PIMS, and the mean age of PIMS children was also above the age of 6 years. Unfortunately, the symptoms of both COVID-19 and PIMS frequently overlap, especially in terms of gastrointestinal symptoms and fever [ 22 , 23 ]. In fact, fever is a mandatory symptom according to the diagnostic criteria of PIMS, but it seems that only half of COVID-19 children develop fever [ 8 , 16 , 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and PIMS—Two Different Entities, but the Same Trigger

et al. 2022

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COVID-19 and PIMS represent two novel pathologies that have challenged the medical world during the last two years on account of their being very similar, but yet very different. Our aim was to comparatively assess children with SARS-CoV-2 infection and PIMS in terms of symptoms, clinical findings, laboratory parameters, echocardiography, and evolution. Our retrospective study included 46 children with COVID-19 (group 1), and 20 children with confirmed PIMS (group 2). We found no significant differences in terms of age, gender, and originating area between the two groups. We noticed that fever was significantly more common in the PIMS group as compared to COVID-19 group (p = 0.0217). In terms of laboratory parameters, increased bilirubin and creatinine were significantly more frequent in children with COVID-19 (p = 0.0064/p = 0.0064), while hypoalbuminemia and elevated ESR were significantly more common in those with PIMS (p < 0.0001/p = 0.0127). Moreover, prognosis parameters such as D-dimers, NT-proBNP, and CK-MB were also found to be significantly higher in the PIMS group as compared to COVID-19 group (p = 0.0003/p = 0.0182/p = 0.0007). In terms of complications, most were identified in PIMS group, among which cardiac and liver impairment along with dehydration were significantly more common in children diagnosed with PIMS as compared to those detected with COVID-19. Similarly, children with PIMS had a significantly higher chance to have pathological echocardiography changes. Although difficult, the distinction between COVID-19 and PIMS is crucial for the patient’s long-term outcome.

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Pediatric Obesity—A Potential Risk Factor for Systemic Inflammatory Syndrome Associated to COVID-19, a Case Report

Cited by 10 publications

References 29 publications

COVID‐19, obesity, and immune response 2 years after the pandemic: A timeline of scientific advances

COVID‐19, obesity, and immune response 2 years after the pandemic: A timeline of scientific advances

SARS-CoV-2 Infection in Filipino Children: An Interim Report from the SALVACION Registry

COVID-19 and PIMS—Two Different Entities, but the Same Trigger

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