Clinical manifestations of COVID-19 differ by age and obesity status.

Abstract

BACKGROUND\nAge 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.\n\n\nMETHODS\nWe prospectively enrolled SARS-CoV-2-exposed individuals. Participants recorded symptoms for 28\u2009days 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.\n\n\nRESULTS\nOf 552 individuals enrolled from June 2020 to January 2021, 470 (85.1%) tested positive for SARS-CoV-2 including 261 (55.5%) adults ≥18\u2009years, 61 (13.0%) adolescents 12-17\u2009years, and 148 (31.5%) children <12\u2009years. Children had fewer symptoms (median 2 vs. 3, p\u2009<\u20090.001) lasting fewer days (median 5 vs. 7, p\u2009<\u20090.001) 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\u2009=\u20090.037), including more cough and shortness of breath (p\u2009=\u20090.023 and 0.026, respectively). Adolescents with OWOB were more likely to be symptomatic (66.7% vs. 34.2%, p\u2009=\u20090.008) and have longer respiratory symptoms (median 7 vs. 4\u2009days, p\u2009=\u20090.049) 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\u2009=\u20090.001 and 0.022).\n\n\nCONCLUSIONS\nAdolescents 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.