Malnutrición por exceso y evolución clínica en niños menores de dos años, hospitalizados por infección respiratoria aguda baja

Abstract

Introduction: obesity is related to a higher morbidity and mortality in adults with respiratory infections but in children the evidence is limited. Objective: to study the association between overweight and clinical course in children younger than two years of age, hospitalized for lower respiratory tract infections (LRTI). Methods: retrospective study reviewing clinical records of children hospitalized by LRTI from 2009 to 2015. Demographic data, anthropometry, nutritional status (World Health Organization [OMS] 2006 reference) and clinical course. Results: we included 678 patients with a median age of 9.9 (range: 6.4 to 14.7) months, 55% were boys and 67% had viral pneumonia (67%). Treatment: 54.7% received basic care, 98.7% oxygen therapy, 35.4% noninvasive ventilation (NIV), 26.1% antibiotics and 47.5% corticosteroids. Regarding nutritional status, 10% had undernutrition (W/Az ≤-1 in infants or W/Hz in the older ones), 55.2% were eutrophic and 34.8% were overweight (ME, W/Hz ≥ +1). Boys with overweight had higher frequency of viral pneumonia (75.4% vs 60.2%, p = 0.014), need for more complex care (27.7% vs 19.9%, p = 0.018) and length of NIV 4.5 [3-5.5] vs. [2-5] days, p = 0.007) than eutrophic. Infants had longer time of NIV than the older ones. In girls, no associations were found between nutritional status and clinical course. Conclusions: in this sample of young children hospitalized with LRTI, obesity and overweight, masculine sex and younger age were associated to worse clinical outcomes.