Obese children and COVID-19

What is the current situation of Covid-19 and children?

As of October 7, 2021, the number of Covid-19 infections among children in the world is reported to be over 6 million, accounting for 16.3% of the total number of infections, the rate of child Covid is 8% (i.e. for every 100). 8 children infected with Covid). The hospitalization rate for Covid-19 in children is 0.1-2%, the mortality rate is 0.03%.

In Ho Chi Minh City, the number of cases of children under 16 years of age with Covid is over 3,000 (with local reports).

Most children with COVID-19 have mild symptoms or no symptoms. However, some children can become seriously ill from COVID-19, requiring hospitalization, intensive care or mechanical ventilation. More dangerous can lead to death, including infants under 1 year of age. And children with certain medical conditions: asthma or chronic lung disease; Diabetes; Genetic, neurological or metabolic disease; Sickle cell disease; Congenital heart disease; Immunodeficiency; Obesity (according to the US CDC).

Obesity and Covid-19 in children

There is now strong evidence that obesity is a risk factor for severe COVID-19 illness and death in both adults and children. Obesity leads to persistent immune dysregulation and increased susceptibility to infections leading to sepsis and death. The hypertrophic adipocytes dysfunctional in obesity produce too many cytokines leading to an increase in macrophages, which produce large amounts of proinflammatory molecules.

Based on data from the COVID-19-related Hospitalization Network (COVID-NET) in July 2020, children with Covid-19 who were hospitalized with obesity accounted for the highest rate (37.8%), followed by children with chronic lung disease and premature birth. Other studies of children hospitalized with COVID-19 show that obesity is the most common underlying medical condition.

Worldwide, there have been reports of severe Covid cases requiring admission to the Intensive Care Unit (ICU) in obese children. These cases had the general condition of obesity with Covid (with or without underlying disease), hospitalization with lung damage, worsening respiratory failure, and progression of Multisystem Inflammatory Syndrome. associated with COVID-19 in children (MIS-C), and requiring intensive care in the ICU.

Recently, at Ho Chi Minh City Children’s Hospital, there was 1 case of a 15 and a half year old child admitted to the hospital with a diagnosis of severe COVID-19, acute respiratory distress syndrome and severe obesity with a weight of 135. kg !! The patient’s breathing was tired, he was heavily obese because he was severely obese, and his lips were purple despite breathing oxygen. X-ray of severely damaged lungs. The baby was diagnosed with severe and critical COVID-19 and must be treated aggressively with high-flow oxygen (HFNC), broad-spectrum antibiotics, high-dose anti-inflammatory, anticoagulation, and supportive care. And after more than 2 weeks of intensive treatment, the patient’s condition has improved.

Through these cases, it can be seen that obesity, even in the absence of additional chronic diseases, increases the risk of complications and severe progression due to SARS-CoV-2 virus infection.

In addition, during the period of social distancing to reduce the transmission of COVID-19, obesity in children is exacerbated. During these pandemic summer months, family routines are disrupted, sleep regulation is disrupted, physical activity is reduced, time spent using electronic devices is increased, access to unhealthy junk food (snack, processed, canned food). And indeed, families continue to face difficulties in managing online learning, limiting physical activity and becoming increasingly dependent on energy-rich processed foods. And childhood obesity rates have risen alarmingly since the start of the Covid pandemic, rising from 13.7% (in 2019) to 15.4% (in 2020).

Therefore, parents need to pay attention to the nutritional status of their children, to avoid overweight and obesity. The monitoring of the growth chart, especially the BMI to detect early overweight and obesity in children, as well as the need for a reasonable diet, to prevent diseases such as diabetes, heart disease. , high blood pressure... and especially to prevent serious complications from Covid-19 during this pandemic.

Dr.Le Thi Kim Dung

References:

https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8172012/

https://pediatrics.aappublications.org/content/147/5/e2021050123\

https://jamanetwork.com/journals/jama/fullarticle/2783690

https://hcdc.vn/hoidap/index/chitiet/4e481bc6f78625aea66215a4b2d0db7d

https://tuoitre.vn/vi-sao-so-ca-f0-tre-em-o-tp-hcm-tang-cao-20210905212305998.htm