Overnutrition as a risk factor for more serious respiratory viral infections in children: A retrospective study in hospitalized patients

Abstract

Background: The prevalence of obesity has increased dramatically in children worldwide. Obesity has been recognized as a risk factor for more serious viral respiratory infections, mainly in adults.

Objective: To study the relationship between overnutrition (obesity and overweight) and clinical severity in children hospitalized with acute respiratory infections of viral origin.

Methods: One hundred and forty-three clinical records of children between 2 and 18 years old hospitalized for acute respiratory infection at Clínica Dávila (2014-2018) were analyzed, recording the respiratory viruses detected at the time of hospitalization, weight, and height. Nutritional status was estimated using Z score or body mass index, according to age.

Results: Eighty-tree3 children (58%) were positive for more than one respiratory virus. The main virus detected in monoinfection was adenovirus (9.8%), followed by respiratory syncytial virus (7.7%) and parainfluenza virus (7.7%). There were no deaths. Patients with obesity presented more days of hospitalization (P = .04), oxygen therapy (P = .03) and mechanical ventilation (P < .001), as well as a higher probability of requiring mechanical ventilation (P = .001) and of ICU admission (P = .003) compared with children with normal weight. Patients with overweight presented more days of mechanical ventilation (P < .001) than patients with normal weight. No significant differences were found between the presence of viral coinfection and nutritional status.

Conclusion: Overnutrition is associated with greater severity of viral respiratory infection in hospitalized children.

Keywords: Children; Clinical severity; Exceso de peso; Gravedad clínica; Menores de edad; Obesidad; Obesity; Overnutrition; Respiratory viral coinfection; Respiratory viruses; Virus respiratorios.