Associação do excesso de peso com gravidade em crianças e adolescentes com covid-19: uma revisão sistemática

Abstract

Background: 100 years ago, on a world scale, there was no tragedy similar to COVID-19, causing such serious health damage, not to mention economic and psychosocial harm. Concomitantly to this pandemic, in the child population there was already another pandemic wave in progress, being alerted by the WHO: childhood obesity. This condition of chronic inflammation causes a drop in the immune system and an increased susceptibility to infections. Numerous studies in adults have been carried out and describe obesity as an independent risk and prognostic factor for the severity of COVID-19, as well as for the need for ICU. Objective: To systematically review the literature on the relationship between overweight and the severity of COVID-19 in children and adolescents. Methods: This systematic review was developed following the PRISMA standards (Preferred Reporting Items for Systematic Review and Meta-Analysis), following the PICO eligibility criteria. The literature search was performed in September 2020, in the following databases: MEDLINE (via PubMed), Embase, Scopus, The Cochrane Library (Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials (CENTRAL)), Web of Science, BVS / LILACS and SciELO. Registration was performed on the PROSPERO platform (International Prospective Registry of Systematic Reviews), under the registration number: CRD42021230686. Results: Of the 667 selected articles, 11 were included according to all agreed criteria, most of them being unicentric and American. In assessing the risk of bias and quality, following the criteria of the Newcastle-Ottawa Scale, eight studies achieved scores higher than 7. Only 5 studies sought to assess obesity and its relationship with worse outcomes (such as need for PICU, MV, tracheostomy, hospital readmission and mortality), and of these, only one article demonstrated this comorbidity as a prognostic factor for worse evolution of the COVID picture. Conclusion: There are few studies in the literature that seek to assess excess weight and its relationship with worse outcomes of COVID-19 in children and adolescents. Taking into account that there is already scientific evidence on this subject in adult patients, it is necessary to carry out more research in the pediatric age group.