185 - Effects of COVID-19 Pandemic on Pediatric Weight: A Retrospective Chart Review

Poster Number: 185
Publication Number: 185.413

Kelly Dopke, Pennsylvania State University College of Medicine, Hershey, PA, United States; Krista Pattison, Penn State College of Medicine, Hershey, PA, United States; Eric Schaefer, Pennsylvania State University College of Medicine, Hershey, PA, United States; Benjamin Fogel, Pennsylvania State University College of Medicine, Hershey, PA, United States; Deepa L. Sekhar, Pennsylvania State University College of Medicine, Hershey, PA, United States

Background: Similar to school districts nationwide, Pennsylvania schools closed in March 2020 due to the COVID-19 pandemic. Students moved to online learning, fostering a more sedentary life. As the pandemic is well-documented to have heightened existing financial disparities in the US population, the impact of weight gain may be unequally distributed as well.

Objective: Evaluate changes in BMI z-scores and weight percentiles of pediatric patients during the COVID-19 pandemic and associated demographics with the goal of identifying those at high risk for excess weight gain.

Design/Methods: This retrospective chart review included pediatric patients 5-18 years-old with a well-visit in each of 3 years (2018, 2019, 2020). BMI z-scores and weight percentiles were analyzed over time using a model appropriate for longitudinal data (correlated errors regression model). The same longitudinal approach was used to model these outcomes over time by patient demographics (sex, race/ethnicity, insurance). To allow for different trajectories over time, interaction terms with time were evaluated for each demographic variable.

Results: The study included 728 patients who met inclusion criteria. Mean age was 9.5 years (2018); patients were 47% female, 70% white and 23% publicly insured. BMI z-score did not increase significantly from 2018-2019 versus 2019-2020. Weight percentile demonstrated a slight increase in trajectory over these same time points (1.2% increase 2018-2019 to 2.4% 2019-2020), a mean change of difference of 1.2 (95% CI 0.2-2.2, p=0.023). In the model that evaluated demographics, publicly insured patients had significantly greater increase in BMI z-score over time compared to privately insured patients (p=0.002). Mean differences between groups increased from 0.26 in 2018 (95% CI: 0.07-0.45) to 0.42 in 2020 (95% CI: 0.23-0.61) Results were similar for weight percentile. [Figure 1]Conclusion(s): Publicly insured pediatric patients experienced a more accelerated increase in BMI-z score and weight percentile during the pandemic than privately insured counterparts. The results confirm existing literature documenting widening disparities as a result of the pandemic. While many schools have resumed in-person instruction, the results support primary care providers targeting at risk subgroups in addressing long-term impacts of the pandemic.
Figure 1Change in BMI z-score and weight percentile in publicly and privately insured pediatric patients