Impact of COVID-19 Diagnosis on Weight Trajectories of Children in the US National COVID Cohort Collaborative

Overview

Journal medRxiv

Date 2025 Jan 13

PMID 39802785

Authors

Md Mozaharul Mottalib

Thao-Ly T Phan

Carolyn T Bramante

Christopher G Chute

Lee A Pyles

Rahmatollah Beheshti

Affiliations

Soon will be listed here.

Abstract

Background: The COVID-19 pandemic has exacerbated the obesity epidemic, with both adults and children demonstrating rapid weight gain during the pandemic. However, the impact of having a COVID-19 diagnosis on this trend is not known.

Methods: Using longitudinal data from January 2019 to June 2023 collected by the US National Institute for Health's National COVID Cohort Collaborative (N3C), children (age 2-18 years) with positive COVID-19 test results (n=11,474, 53% male, mean [SD] age 5.57 [±3.29] years, 54% white, mean [SD] 5.2 [±2.9] BMI observations per participants) were matched with COVID-19 negative children with identical demographic characteristics and similar observation window. We compared BMI percentile trajectories between the COVID-19 positive and COVID-19 negative cohorts, with further evaluation performed on COVID-19 positive patients stratified by hospitalization status.

Results: COVID-19 positive patients had a greater increase in than COVID-19 negative patients (average increase of 2.34 (±7.73) compared to 1.46 (±6.09), p<0.0005). COVID-19 positive patients gained more weight after their diagnosis of COVID-19 than before. Non-hospitalized children gained more weight than hospitalized children (average increase in of 2.38 (±7.65)) compared to 1.87 (±8.54)). Mixed effect regression analyses demonstrated that these associations remained even after adjusting for time, demographics, and baseline .

Conclusions: Having a COVID-19 diagnosis was associated with more rapid weight gain, especially after diagnosis and early in the pandemic. Future research should explore the reasons for this association and the implications for future health emergencies.

References

Sharafeldin N, Bates B, Song Q, Madhira V, Yan Y, Dong S . Outcomes of COVID-19 in Patients With Cancer: Report From the National COVID Cohort Collaborative (N3C). J Clin Oncol. 2021; 39(20):2232-2246. PMC: 8260918. DOI: 10.1200/JCO.21.01074. View

Estrada E, Ferrer E, Pardo A . Statistics for Evaluating Pre-post Change: Relation Between Change in the Distribution Center and Change in the Individual Scores. Front Psychol. 2019; 9:2696. PMC: 6331475. DOI: 10.3389/fpsyg.2018.02696. View

Koletzko B, Holzapfel C, Schneider U, Hauner H . Lifestyle and Body Weight Consequences of the COVID-19 Pandemic in Children: Increasing Disparity. Ann Nutr Metab. 2021; 77(1):1-3. PMC: 7900479. DOI: 10.1159/000514186. View

Zhang T, Mei Q, Zhang Z, Walline J, Liu Y, Zhu H . Risk for newly diagnosed diabetes after COVID-19: a systematic review and meta-analysis. BMC Med. 2022; 20(1):444. PMC: 9666960. DOI: 10.1186/s12916-022-02656-y. View

Lange S, Kompaniyets L, Freedman D, Kraus E, Porter R, Blanck H . Longitudinal Trends in Body Mass Index Before and During the COVID-19 Pandemic Among Persons Aged 2-19 Years - United States, 2018-2020. MMWR Morb Mortal Wkly Rep. 2021; 70(37):1278-1283. PMC: 8445379. DOI: 10.15585/mmwr.mm7037a3. View

Umano G, Rondinelli G, Rivetti G, Klain A, Aiello F, Miraglia Del Giudice M . Effect of COVID-19 Lockdown on Children's Eating Behaviours: A Longitudinal Study. Children (Basel). 2022; 9(7). PMC: 9323163. DOI: 10.3390/children9071078. View

Mottalib M, Jones-Smith J, Sheridan B, Beheshti R . Subtyping patients with chronic disease using longitudinal BMI patterns. IEEE J Biomed Health Inform. 2023; PP. PMC: 10350469. DOI: 10.1109/JBHI.2023.3237753. View

Lin A, Vittinghoff E, Olgin J, Pletcher M, Marcus G . Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study. JAMA Netw Open. 2021; 4(3):e212536. PMC: 7985720. DOI: 10.1001/jamanetworkopen.2021.2536. View

Nilsen A, Anderssen S, Johannessen K, Nyvoll Aadland K, Ylvisaaker E, Loftesnes J . Bi-directional prospective associations between objectively measured physical activity and fundamental motor skills in children: a two-year follow-up. Int J Behav Nutr Phys Act. 2020; 17(1):1. PMC: 6941400. DOI: 10.1186/s12966-019-0902-6. View

Woolford S, Sidell M, Li X, Else V, Young D, Resnicow K . Changes in Body Mass Index Among Children and Adolescents During the COVID-19 Pandemic. JAMA. 2021; 326(14):1434-1436. PMC: 8511973. DOI: 10.1001/jama.2021.15036. View

10.

Kompaniyets L, Agathis N, Nelson J, Preston L, Ko J, Belay B . Underlying Medical Conditions Associated With Severe COVID-19 Illness Among Children. JAMA Netw Open. 2021; 4(6):e2111182. PMC: 8185607. DOI: 10.1001/jamanetworkopen.2021.11182. View

11.

Freedman D, Davies A, Kompaniyets L, Lange S, Goodman A, Phan T . A Longitudinal Comparison of Alternatives to Body Mass Index Z-Scores for Children with Very High Body Mass Indexes. J Pediatr. 2021; 235:156-162. DOI: 10.1016/j.jpeds.2021.02.072. View

12.

Hales C, Carroll M, Fryar C, Ogden C . Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief. 2017; (288):1-8. View

13.

Fayyaz H, Phan T, Bunnell H, Beheshti R . Predicting Attrition Patterns from Pediatric Weight Management Programs. Proc Mach Learn Res. 2023; 193:326-342. PMC: 9854275. View

14.

Bennett T, Moffitt R, Hajagos J, Amor B, Anand A, Bissell M . Clinical Characterization and Prediction of Clinical Severity of SARS-CoV-2 Infection Among US Adults Using Data From the US National COVID Cohort Collaborative. JAMA Netw Open. 2021; 4(7):e2116901. PMC: 8278272. DOI: 10.1001/jamanetworkopen.2021.16901. View

15.

Stavridou A, Kapsali E, Panagouli E, Thirios A, Polychronis K, Bacopoulou F . Obesity in Children and Adolescents during COVID-19 Pandemic. Children (Basel). 2021; 8(2). PMC: 7918914. DOI: 10.3390/children8020135. View

16.

Anderson L, Yoshida-Montezuma Y, Dewart N, Jalil E, Khattar J, De Rubeis V . Obesity and weight change during the COVID-19 pandemic in children and adults: A systematic review and meta-analysis. Obes Rev. 2023; 24(5):e13550. DOI: 10.1111/obr.13550. View

17.

Vogel M, Geserick M, Gausche R, Beger C, Poulain T, Meigen C . Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic. Int J Obes (Lond). 2021; 46(1):144-152. PMC: 8458556. DOI: 10.1038/s41366-021-00968-2. View

18.

Tanskey L, Goldberg J, Chui K, Must A, Sacheck J . The State of the Summer: a Review of Child Summer Weight Gain and Efforts to Prevent It. Curr Obes Rep. 2018; 7(2):112-121. PMC: 6857933. DOI: 10.1007/s13679-018-0305-z. View

19.

Almandoz J, Xie L, Schellinger J, Mathew M, Gazda C, Ofori A . Impact of COVID-19 stay-at-home orders on weight-related behaviours among patients with obesity. Clin Obes. 2020; 10(5):e12386. PMC: 7300461. DOI: 10.1111/cob.12386. View