Childhood Obesity and Risk of SARS-CoV-2 Infection

Objective: To estimate the association between childhood obesity and the risk of SARS-CoV-2 infection in a cohort followed from 4 to 12 years of age. Methods: The data were obtained from 2018 participants in the Longitudinal Study of Childhood Obesity (ELOIN) and from epidemiological surveillance data for the Community of Madrid (Spain), which was used to identify the population within the cohort with confirmed SARS-CoV-2 infection. The SARS-CoV-2 registry was cross-checked when this population was 11-12 years old. Through physical examinations at 4, 6 and 9 years of age, weight, height and waist circumference were obtained. The WHO-2007 criteria were used to classify general obesity (GO), and the International Diabetes Federation (IDF) criteria were used to classify abdominal obesity (AO). Using Poisson regression, the relative risks (RRs) of infection were estimated, adjusting for sociodemographic variables, physical activity and perceived health reported by the parents. Results: The accumulated incidence of SARS-CoV-2 infection was 8.6% (95% CI: 7.3-9.8). Compared with that for children who did not have GO at 4-9 years, the RR of SARS-CoV-2 infection for those with stable GO at these ages was 2.53 (95% CI: 1.56-4.10), with an estimated RR of 2.56 (95% CI: 1.55-4.21) for children with AO. Conclusions: Childhood obesity is an independent risk factor for SARS-CoV-2 infection. This study provides new evidence that indicates that obesity increases the vulnerability of the paediatric population to infectious diseases. Funding: This study was funded by the Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP) and the Regional Ministry of Health of the Community of Madrid through non-refundable grants from the credits awarded to the Community of Madrid by the Spanish Government Fund COVID-19, included in Order HAC/667/2020. Declaration of Interest: None to declare. Ethical Approval: The study protocol was approved by the Ethics Committee of Hospital Ramon y Cajal (Ramon y Cajal Hospital in Madrid).