Summary Background Obesity increases the severity of coronavirus disease 2019 illness in adults. The role of obesity in short‐term complications and post‐acute sequelae in children is not well defined. Objective To evaluate the relationship between obesity and short‐term complications and post‐acute sequelae of SARS‐CoV‐2 infection in hospitalized paediatric patients. Methods An observational study was conducted in three tertiary hospitals, including paediatric hospitalized patients with a confirmatory SARS‐CoV‐2 RT‐PCR from March 2020 to December 2021. Obesity was defined according to WHO 2006 (0–2 years) and CDC 2000 (2–20 years) growth references. Short‐term outcomes were intensive care unit admission, ventilatory support, superinfections, acute kidney injury, and mortality. Neurological, respiratory, and cardiological symptoms and/or delayed or long‐term complications beyond 4 weeks from the onset of symptoms were considered as post‐acute sequalae. Adjusted linear, logistic regression and generalized estimating equations models were performed. Results A total of 216 individuals were included, and 67 (31.02%) of them had obesity. Obesity was associated with intensive care unit admission (aOR = 5.63, CI95% 2.90–10.94), oxygen requirement (aOR = 2.77, CI95% 1.36–5.63), non‐invasive ventilatory support (aOR = 6.81, CI95% 2.11–22.04), overall superinfections (aOR = 3.02 CI95% 1.45–6.31), and suspected bacterial pneumonia (aOR = 3.00 CI95% 1.44–6.23). For post‐acute sequalae, obesity was associated with dyspnea (aOR = 9.91 CI95% 1.92–51.10) and muscle weakness (aOR = 20.04 CI95% 2.50–160.65). Conclusions In paediatric hospitalized patients with COVID‐19, severe short‐term outcomes and post‐acute sequelae are associated with obesity. Recognizing obesity as a key comorbidity is essential to develop targeted strategies for prevention of COVID‐19 complications in children.

Letters to the Editor age. The potential triggers for TE are an acute illness with fever, systemic diseases, severe emotional stress, major surgery, rapid weight loss, nutritional deficiency, endocrine disorders and drug exposure. Acute TE occurs within 2-3 months after the triggering event and usually resolves itself on its own or if the trigger is eliminated. 2 Hair loss due to TE has been reported in adult patients following COVID-19 infection, 3 and only 1 pediatric patient with MIS-C. 4 This case highlights that hair loss may occur as a late complication of MIS-C. Future studies are needed to define the long-term complications of MIS-C.

We identified four systematic reviews, including 20 randomized trials overall. We concluded the use of systemic corticosteroids has no benefit for the treatment of bronchiolitis, even for patients with mechanical ventilation.