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. 2022 Mar;16(2):255-264.
doi: 10.1111/irv.12918. Epub 2021 Oct 19.

Clinical manifestations of COVID-19 differ by age and obesity status

Wesley A Cheng  1 , Lauren Turner  1 , Carolyn J Marentes Ruiz  1 , Melissa L Tanaka  1 , Zion Congrave-Wilson  1 , Yesun Lee  1 , Jaycee Jumarang  1 , Stephanie Perez  1 , Ariana Peralta  1 , Pia S Pannaraj  1   2
Affiliations

Clinical manifestations of COVID-19 differ by age and obesity status

Wesley A Cheng et al. Influenza Other Respir Viruses. 2022 Mar.

Abstract

Background: Age and obesity status are associated with severe outcomes among hospitalized individuals with COVID-19. It remains unclear whether age and obesity are risk factors for milder COVID-19 illness.

Methods: We prospectively enrolled SARS-CoV-2-exposed individuals. Participants recorded symptoms for 28 days and were tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) and serology. Type, number, and duration of symptoms and SARS-CoV-2 laboratory parameters were compared by age and obesity status.

Results: Of 552 individuals enrolled from June 2020 to January 2021, 470 (85.1%) tested positive for SARS-CoV-2 including 261 (55.5%) adults ≥18 years, 61 (13.0%) adolescents 12-17 years, and 148 (31.5%) children <12 years. Children had fewer symptoms (median 2 vs. 3, p < 0.001) lasting fewer days (median 5 vs. 7, p < 0.001) compared with adolescents/adults. Body mass index of 300 (63.8%) individuals classified with overweight or obesity (OWOB). Individuals with OWOB suffered more symptoms compared with individuals without OWOB (median 3 vs. 2, p = 0.037), including more cough and shortness of breath (p = 0.023 and 0.026, respectively). Adolescents with OWOB were more likely to be symptomatic (66.7% vs. 34.2%, p = 0.008) and have longer respiratory symptoms (median 7 vs. 4 days, p = 0.049) compared with adolescents without OWOB. Lower RT-PCR Ct values were found in children and symptomatic individuals compared with adolescent and adults and asymptomatic individuals, respectively (p = 0.001 and 0.022).

Conclusions: Adolescents and adults with OWOB experience more respiratory symptoms from COVID-19 despite similar viral loads. These findings underscore the importance of vaccinating individuals with OWOB.

Keywords: COVID-19; SARS-CoV-2; adolescents; children; obesity.

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Conflict of interest statement

P. S. P. receives research funding from AstraZeneca and Pfizer for unrelated non‐COVID‐19 studies. She also has received consultant fees from Sanofi‐Pasteur and Seqirus. All other authors have no conflicts of interest to report.

Figures

FIGURE 1
FIGURE 1
Symptoms in adolescents and adults ≥12 years old (yo) versus children <12 yo. Children <12 yo experience more fever and diarrhea, but adolescents and adults have more chills, headache, fatigue, muscle aches, sore throat, cough, shortness of breath, and altered smell and taste (all p < 0.05). Fever and cough lasted longer in adults and adolescents (p = 0.016 and 0.001, respectively)
FIGURE 2
FIGURE 2
Symptoms in individuals with overweight and obese (OWOB) compared with individuals without OWOB. Individuals with OWOB experienced more cough, shortness of breath, and altered taste compared with individuals without OWOB (p = 0.023, 0.026, and 0.045, respectively). The duration of symptoms was similar between the two groups
FIGURE 3
FIGURE 3
COVID‐19 associated symptoms by age group and obesity status. Adolescents 12–17 years old (yo) with overweight and obese (OWOB) experience more constitutional and respiratory symptoms compared with adolescents without OWOB (p = 0.020 and 0.010, respectively)
See this image and copyright information in PMC

References

    1. Castagnoli R, Votto M, Licari A, et al. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in children and adolescents: a systematic review. JAMA Pediatr. 2020;174(9):882‐889. - PubMed
    1. Kompaniyets L, Goodman AB, Belay B, et al. Body mass index and risk for COVID‐19‐related hospitalization, intensive care unit admission, invasive mechanical ventilation, and death—United States, March–December 2020. MMWR Morb Mortal Wkly Rep. 2021;70(10):355‐361. - PMC - PubMed
    1. Leidman E, Duca LM, Omura JD, Proia K, Stephens JW, Sauber‐Schatz EK. COVID‐19 trends among persons aged 0–24 years—United States, March 1–December 12, 2020. MMWR Morb Mortal Wkly Rep. 2021;70(3):88‐94. - PMC - PubMed
    1. Havers FP, Whitaker M, Self JL, et al. Hospitalization of adolescents aged 12–17 years with laboratory‐confirmed COVID‐19—COVID‐NET, 14 States, March 1, 2020–April 24, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(23):851‐857. - PMC - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID‐19 in the New York City area. JAMA. 2020;323(20):2052‐2059. - PMC - PubMed

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