tetano
Editor, Senior Moderator
Eur J Pediatr
. 2022 Nov 11.
doi: 10.1007/s00431-022-04689-0. Online ahead of print.
Obesity as a risk factor for severe influenza infection in children and adolescents: a systematic review and meta-analysis
Dimitra-Irinna Vitoratou[SUP] 1 [/SUP], Gerasimos-Panagiotis Milas[SUP] 2 [/SUP], Paraskevi Korovessi[SUP] 1 [/SUP], Stavroula Kostaridou[SUP] 1 [/SUP], Patra Koletsi[SUP] 1 [/SUP]
Affiliations
Abstract
Obesity has been recently identified as a predisposing factor for a worse prognosis in viral illnesses such as SARS-CoV-2; however, its role in children with influenza is not yet clarified. The current systematic review and meta-analysis aims to assess whether obesity is a risk factor for either hospitalization or a worse prognosis when hospitalized among children infected by influenza. We systematically searched the following databases using a structured algorithm: MEDLINE, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL). Statistical meta-analysis was performed using the "meta" package in R software, and included studies were evaluated using the Newcastle-Ottawa scale. Among children with influenza, obesity increased the odds of hospitalization with a pooled OR of 1.89 (95% CI [1.23, 2.9], I[SUP]2[/SUP] = 0, p = 0.003). When hospitalized, children with obesity were also more likely to have a worse outcome than their healthy-weight counterparts, with a pooled OR of 1.24 (95% Cl [1.02; 1.51], I[SUP]2[/SUP] = 11, p = 0.03). In an effort to lower heterogeneity, a leave-one-out meta-analysis was conducted. Publication bias was assessed with the visual inspection of funnel plots and the trim-and-fill method. Certainty assessment was evaluated using the GRADE score.
Conclusions: The findings of our meta-analysis suggest that obesity in children with influenza is associated with a worse prognosis, both hospitalization and ICU admission/death.
What is known: • Obesity has been identified as a risk factor for non-communicable as well as communicable diseases. • A previous meta-analysis failed to demonstrate a statistically significant association between obesity and influenza infection severity.
What is new: • Children with high BMI and influenza infection are more likely to get hospitalized. • Pediatric inpatients with increased BMI and influenza infection may have a worse prognosis.
Keywords: Hospitalization; Influenza; Obesity; Risk factor.
. 2022 Nov 11.
doi: 10.1007/s00431-022-04689-0. Online ahead of print.
Obesity as a risk factor for severe influenza infection in children and adolescents: a systematic review and meta-analysis
Dimitra-Irinna Vitoratou[SUP] 1 [/SUP], Gerasimos-Panagiotis Milas[SUP] 2 [/SUP], Paraskevi Korovessi[SUP] 1 [/SUP], Stavroula Kostaridou[SUP] 1 [/SUP], Patra Koletsi[SUP] 1 [/SUP]
Affiliations
- PMID: 36369400
- DOI: 10.1007/s00431-022-04689-0
Abstract
Obesity has been recently identified as a predisposing factor for a worse prognosis in viral illnesses such as SARS-CoV-2; however, its role in children with influenza is not yet clarified. The current systematic review and meta-analysis aims to assess whether obesity is a risk factor for either hospitalization or a worse prognosis when hospitalized among children infected by influenza. We systematically searched the following databases using a structured algorithm: MEDLINE, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL). Statistical meta-analysis was performed using the "meta" package in R software, and included studies were evaluated using the Newcastle-Ottawa scale. Among children with influenza, obesity increased the odds of hospitalization with a pooled OR of 1.89 (95% CI [1.23, 2.9], I[SUP]2[/SUP] = 0, p = 0.003). When hospitalized, children with obesity were also more likely to have a worse outcome than their healthy-weight counterparts, with a pooled OR of 1.24 (95% Cl [1.02; 1.51], I[SUP]2[/SUP] = 11, p = 0.03). In an effort to lower heterogeneity, a leave-one-out meta-analysis was conducted. Publication bias was assessed with the visual inspection of funnel plots and the trim-and-fill method. Certainty assessment was evaluated using the GRADE score.
Conclusions: The findings of our meta-analysis suggest that obesity in children with influenza is associated with a worse prognosis, both hospitalization and ICU admission/death.
What is known: • Obesity has been identified as a risk factor for non-communicable as well as communicable diseases. • A previous meta-analysis failed to demonstrate a statistically significant association between obesity and influenza infection severity.
What is new: • Children with high BMI and influenza infection are more likely to get hospitalized. • Pediatric inpatients with increased BMI and influenza infection may have a worse prognosis.
Keywords: Hospitalization; Influenza; Obesity; Risk factor.