Post-acute dyslipidemia and abnormal body mass index in children and adolescents with COVID-19: A cohort study from the RECOVER Initiative
Lei, Y; Zhou, T; Zhang, B; et al., The Journal of Pediatrics, January 2026
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Short Summary
This RECOVER study looked at whether COVID-19 was linked to a higher risk for dyslipidemia (unusual levels of fats or cholesterol in the blood) or a high body mass index (BMI) in children and young adults. BMI is a number that helps show if someone's weight is in the healthy range for their height. A higher BMI can be a sign that a person may be overweight or have obesity. Researchers looked at the electronic health records (EHRs) of over one million children and young adults, from birth to age 21, across 25 different children’s hospitals in the US. Researchers followed the health of children and young adults for up to 6 months after they got COVID-19 for the first time and compared them to a group of children and young adults who did not get COVID-19. Researchers found that children and young adults who got COVID-19 were about 24% more likely to develop dyslipidemia and 15% more likely to develop a high or unhealthy BMI than those who never had COVID-19. These findings are important because they show that COVID-19 may be linked to a higher risk of health problems related to blood fats and weight. These findings also highlight the need for closer follow-up of children and young adults during their recovery from COVID-19.
This summary was prepared by the RECOVER Initiative.
Publication Details
DOI: 10.1016/j.jpeds.2026.114996
Abstract
Objective: To evaluate the risks of incident dyslipidemia and abnormal body mass index (BMI) during the 28-179-day postacute phase after documented SARS-CoV-2 infection in a large pediatric sample.
Study design: A retrospective cohort study using the Researching COVID to Enhance Recovery pediatric electronic health record datasets from 25 US children's hospitals and health institutions, from March 2020 to September 2023. This study included 384 289 COVID-19-positive patients aged 0-21 years for dyslipidemia analyses and 285 559 aged 2-21 years for BMI analyses, each with at least 6 months of follow-up. COVID-19-negative controls included 1 080 413 and 817 315 patients, respectively. SARS-CoV-2 infection was defined by a positive polymerase chain reaction, antigen, or serologic test; a clinical diagnosis of COVID-19; or a documented diagnosis of post-acute sequelae of SARS-CoV-2. Incident dyslipidemia and abnormal BMI were identified using age-specific laboratory or anthropometric thresholds. Adjusted relative risks (aRRs) were estimated using propensity-score-stratified modified Poisson regression with multiple sensitivity analyses.
Results: During the postacute phase, the COVID-19-positive cohort had higher rates of new-onset composite dyslipidemia (aRR 1.24; 95% CI 1.18-1.29) and abnormal BMI (aRR 1.15; 95% CI, 1.12-1.18). Results were robust to sensitivity and stratified analyses.
Conclusions: Children and adolescents with documented COVID-19 infection were associated with an increased risk of new-onset dyslipidemia and abnormal BMI during the postacute phase, highlighting the need for metabolic monitoring after infection.
Authors
Yuqing Lei, Ting Zhou, Bingyu Zhang, Dazheng Zhang, Huilin Tang, Jiajie Chen, Qiong Wu, Lu Li, L Charles Bailey, Michael J Becich, Saul Blecker, Dimitri A Christakis, Daniel Fort, Sharon J Herring, Wenke Hwang, Amrik Singh Khalsa, Susan Kim, David M Liebovitz, Abu Saleh Mohammad Mosa, Suchitra Rao, Soumitra Sengupta, Xing Song, Yacob G Tedla, Ravi Jhaveri, Caren Mangarelli, Christopher B Forrest, Yong Chen, RECOVER Consortium
Keywords
EHR; dyslipidaemia; metabolic health; obesity; pediatric population; postacute sequelae of SARS-CoV-2 (PASC)