This study aimed to systematically assess COVID‐19 patient background characteristics and pre‐existing comorbidities associated with hospitalisation status. The meta‐analysis included cross‐sectional, cohort, and case‐series studies with information on hospitalisation versus outpatient status for COVID‐19 patients, with background characteristics and pre‐existing comorbidities. A total of 1,002,006 patients from 40 studies were identified. Significantly higher odds of hospitalisation were observed in Black individuals (OR = 1.33, 95% CI: 1.04–1.70), males (OR = 1.59, 95% CI: 1.43–1.76), and persons with current/past smoking (OR = 1.59, 95% CI: 1.34–1.88). Additionally, individuals with pre‐existing comorbidities were more likely to be hospitalised [asthma (OR = 1.22, 95% CI: 1.02–1.45), COPD (OR = 3.68, 95% CI: 2.97–4.55), congestive heart failure (OR = 6.80, 95% CI: 4.97–9.31), coronary heart disease (OR = 4.40, 95% CI: 3.15–6.16), diabetes (OR = 3.90, 95% CI: 3.29–4.63), hypertension (OR = 3.89, 95% CI: 3.34–4.54), obesity (OR = 1.98, 95% CI: 1.59–2.46) and renal chronic disease (OR = 5.84, 95% CI: 4.51–7.56)]. High heterogeneity and low publication bias among all factors were found. Age was not included due to the large variability in the estimates reported. In this systematic review/meta‐analysis for patients with COVID‐19, Black patients, males, persons who smoke, and those with pre‐existing comorbidities were more likely to be hospitalised than their counterparts. Findings provide evidence of populations with higher odds of hospitalisation for COVID‐19.

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Background Childhood cognitive development is influenced by biological and environmental factors. One such factor, obesity, impairs cognitive development and is associated with sleep disturbances (SDs). Objective To examine the mediating role of SDs on the relationship between body mass index (BMI) and cognitive function in children. Methods A total of 9951 children aged 9–10 years were included in this cross-sectional study. Children were recruited from the longitudinal Adolescent Brain Cognitive Development (ABCD) Study. Cognitive development was assessed using metrics for fluid, crystallized, and total cognitive function. Mediation analyses were conducted via linear regression modeling, with adjustment for potential confounders (sex, age, ethnicity, household income, parental education, and self-reported physical activity) for each of the three outcomes. Mediation significance was determined by bootstrapping. Results A statistically significant inverse association was found between BMI and total (β = −0.41, P < 0.001) and fluid (β = −0.49, P < 0.001) cognition, but not for crystallized cognition. Total sleep disturbances partially mediated the association between BMI and fluid cognition (indirect effect: -0.02, P = 0.002; proportion on the total effect: 0.05, P = 0.002), but no mediation was found in the association between BMI and total cognition. Conclusions Sleep disturbances partially mediate the effect of childhood obesity on cognitive function, particularly in fluid cognitions. Future work is necessary to understand the effects of sleep disturbances, and obesity on reduced childhood cognition throughout time, predominantly, across the life course.

Published in the Journals of Gerontology Series A: Biological Sciences as a letter to the editor: https://doi.org/10.1093/gerona/glaa041

Objectives Childhood cognitive development is influenced by biological and environmental factors. One such factor, obesity, impairs cognitive development and is associated with sleep disturbances (SDs). We examined the mediating role of SDs on the relationship between obesity and cognitive function in children from a large longitudinal study. Methods A total of 9951 children aged 9–11 years were included in this study. Children were recruited from 21 centers across the US from the Adolescent Brain Cognitive Development (ABCD) study. We assessed cognitive development using metrics for fluid (adaptation and new learning abilities), crystallized (experience-dependent abilities), and total cognitive function. Mediation analyses were conducted via linear regression modeling, with adjustment for potential confounders (sex, age, ethnicity, household income, parental education, and self-reported physical activity) for each of the 3 cognitive outcomes. Mediation significance was determined by bootstrapping. We also stratified our analyses by race (Caucasian, African-American, other racial minorities) to examine potential racial differences. Results We found a statistically significant inverse association between BMI and both total (β = −0.41, P < 0.001) and fluid (β = −0.49, P < 0.001) cognitive function. Stratified regression analyses found similar results for the Caucasians and other minorities groups, for both, fluid (Caucasian: β = −0.52, P < 0.001; other minorities β = −0.75, P = 0.01) and total cognitive function (Caucasian: β = −0.45, P < 0.001; other ethnicities: β = −0.76, P = 0.01). No association was observed among African Americans. Overall mediation analysis revealed that SDs were a partial mediator only for fluid cognitive function (P = 0.002). Further mediation analyses showed similar SDs partial mediation effects over fluid cognitive function in Caucasians (P = 0.002) and borderline significant mediation in the other minorities group (P = 0.06). Conclusions Our results suggest that SDs mediates the effect of obesity on cognitive functioning in children and that these effects vary across races, particularly as it pertains to fluid cognition. Fluid cognition is critical in childhood neurodevelopment, and further research is needed to address its long-term effects across the life course. Funding Sources None to declare.