Clinical manifestations of COVID‐19 differ by age and obesity status

Abstract

Background Age and obesity status are associated with severe outcomes among hospitalized individuals with COVID‐19. It remains unclear whether age and obesity are risk factors for milder COVID‐19 illness. Methods We prospectively enrolled SARS‐CoV‐2‐exposed individuals. Participants recorded symptoms for 28 days and were tested for SARS‐CoV‐2 by reverse transcription polymerase chain reaction (RT‐PCR) and serology. Type, number, and duration of symptoms and SARS‐CoV‐2 laboratory parameters were compared by age and obesity status. Results Of 552 individuals enrolled from June 2020 to January 2021, 470 (85.1%) tested positive for SARS‐CoV‐2 including 261 (55.5%) adults ≥18 years, 61 (13.0%) adolescents 12–17 years, and 148 (31.5%) children <12 years. Children had fewer symptoms (median 2 vs. 3, p < 0.001) lasting fewer days (median 5 vs. 7, p < 0.001) compared with adolescents/adults. Body mass index of 300 (63.8%) individuals classified with overweight or obesity (OWOB). Individuals with OWOB suffered more symptoms compared with individuals without OWOB (median 3 vs. 2, p = 0.037), including more cough and shortness of breath ( p = 0.023 and 0.026, respectively). Adolescents with OWOB were more likely to be symptomatic (66.7% vs. 34.2%, p = 0.008) and have longer respiratory symptoms (median 7 vs. 4 days, p = 0.049) compared with adolescents without OWOB. Lower RT‐PCR Ct values were found in children and symptomatic individuals compared with adolescent and adults and asymptomatic individuals, respectively ( p = 0.001 and 0.022). Conclusions Adolescents and adults with OWOB experience more respiratory symptoms from COVID‐19 despite similar viral loads. These findings underscore the importance of vaccinating individuals with OWOB.

Clinical features and severe acute respiratory syndrome-coronavirus-2 structural protein-based serology of Mexican children and adolescents with coronavirus disease 2019

“…Symptoms such as fever, cough, headache, and odynophagia with sudden onset of symptoms and attack on the general state were primarily reported in this Mexican population; such symptoms are in agreement with those previously reported by Rajakapse et al [28]. Similar to previous reports, underlying conditions such as asthma and obesity were also associated with severe COVID-19 in Mexican children admitted to HIMFG [8,25,29,30]. In contrast to other studies, in which fever, cough, tachypnea, general malaise, nasal congestion, rhinorrhea, refusal to feed/difficulty feeding, and diarrhea were reported as the most common symptoms, we observed that the children and adolescents without comorbidities had rhinorrhea and polypnea as the major symptoms [31].…”

COVID-19 Induced Taste Dysfunction and Recovery: Association with Smell Dysfunction and Oral Health Behaviour

“…Vitamin D levels have been found to be significantly different in those with or without taste loss in COVID-19 [55]. Regarding BMI, the duration of taste loss did not significantly differ between overweight/obese and normal weight participants, although those with higher BMI did appear to have a greater frequency of taste loss but not smell loss [56]. Sex is perhaps the most widely studied variable in associated with sensory disruption.…”

Increased risk of mortality from COVID-19 in people with obesity

“…Essas alterações fisiológicas supracitadas resultantes da obesidade podem explicar os achados encontrados nos Estados Unidos, onde os indivíduos com sobrepeso ou obesidade, comparados às pessoas com peso dentro da normalidade, apresentaram mais sintomas, especialmente, os sintomas respiratórios que incluíam tosse e falta de ar (17) .…”

“…Em relação à frequência dos sintomas, duração e níveis de gravidade autorrelatados por adolescentes obesos e com sobrepeso foram semelhantes aos de adultos. Os adolescentes apresentaram mais sintomas com maior gravidade autorreferida que durou mais tempo do que as crianças menores de 12 anos (17) . Esse achado pode ser um indicativo de ausência de sintomas ou sintomatologia branda em crianças menores e que podem não ser associados à infecção por SARS--CoV-2, o que pode dificultar o diagnóstico e resultar em subnotificação nesse grupo da população.…”