Impact of the COVID-19 pandemic on cardiometabolic health parameters in children with preexisting dyslipidemia

BACKGROUND: The COVID-19 pandemic has raised concerns for worsening cardiometabolic health in children. OBJECTIVE: This study evaluates the impact of the COVID-19 pandemic and subsequent social restrictions on pediatric cardiometabolic health factors. METHODS: Retrospective review of patients in a pediatric lipid clinic in the year prior to (3/18/2019-3/17/2020) and during (3/18/2020-3/17/2021) the COVID-19 pandemic was performed. Physical findings (body mass index [BMI], waist circumference [WC], and blood pressure), laboratory markers of cardiometabolic health (lipid panel, insulin resistance, and liver transaminases), self-reported exercise time, and lipid-lowering medications (metformin, statin, omega-3 fatty acids, fenofibrate) were compared. RESULTS: 297 subjects met inclusion criteria. Among subjects prescribed no medications or on stable medication doses (n=241), there were few changes in lipid panels. Among subjects with new or increased medication doses between pre-pandemic and pandemic intervals (n=62), there were increases in triglycerides (p= 0.019) and HgbA1c (p=0.046). There was no change in z-scores for both BMI and WC for either group. CONCLUSION: We observed concerning trends in markers of cardiovascular disease health (dyslipidemia, insulin resistance, and diabetes), independent of changes in weight, in at-risk children during the recent COVID pandemic. Our findings suggest that this vulnerable population may benefit from more frequent monitoring and intense management during such events.