Skip to main content Skip to main navigation menu Skip to site footer

Unique problems of pneumonia in obese children: a literature review


Background: Obesity in children has its impact when the child experiences infectious conditions common in childhood, such as pneumonia. The increasing incidence of obesity in children in the last three decades forms the basis for compiling this review article. This review article aims to provide current insights about the impact of obesity on respiratory physiology, inflammatory conditions in pneumonia, and drug pharmacodynamics.

Methods: This literature review uses the latest literature relevant to matters affecting pneumonia management and clinical approach in children with obesity. This literature was obtained from various sources of other scientific literature.

Results: Obesity affects the respiratory physiology of children to collapse more easily, energy use becomes less efficient, children become tired, and hypoxemia occurs easily. Obesity also increases the degree and ease of inflammation in pneumonia and affects the pharmacodynamics of several drugs commonly used to manage pneumonia.

Conclusion: Management of pneumonia in children with obesity requires vigilance and more stringent monitoring and adjustment of drug doses.


  1. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3-21.
  2. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-2642.
  3. Oddo VM, Maehara M, Rah JH. Overweight in Indonesia: an observational study of trends and risk factors among adults and children. BMJ Open. 2019;9(9):e031198.
  4. Hendarto A. The burden of childhood obesity in Indonesia. International Journal of Clinical Pediatrics and Child Health. 2019;1(1):21-7.
  5. Sulistyawati S, Sofiana L, Amala SK, Rokhmayanti R, Astuti FD, Nurfita D. Pneumonia a neglected disease: A mixed-method study on the case-finding program in Indonesia. AIMS Public Health. 2020;7(1):81-91.
  6. McAllister DA, Liu L, Shi T, Chu Y, Reed C, Burrows J, Adeloye D, Rudan I, Black RE, Campbell H, Nair H. Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis. Lancet Glob Health. 2019;7(1):e47-e57.
  7. Ferreira MS, Marson FAL, Wolf VLW, Ribeiro JD, Mendes RT. Lung function in obese children and adolescents without respiratory disease: a systematic review. BMC Pulm Med. 2020;20(1):281.
  8. Lutfi MF. The physiological basis and clinical significance of lung volume measurements. Multidiscip Respir Med. 2017;12(1):1-12.
  9. Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med. 2018 ;12(9):755-767.
  10. Ellulu MS, Patimah I, Khaza'ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13(4):851-863.
  11. Maffeis L, Agostoni CV, Marafon DP, Terranova L, Giavoli C, Milani GP, et al. Cytokines Profile and Lung Function in Children with Obesity and Asthma: A Case-Control Study. Children (Basel). 2022;9(10):1462.
  12. Alarcon PC, Damen MSMA, Madan R, Deepe GS Jr, Spearman P, Way S, et al. Adipocyte inflammation and pathogenesis of viral pneumonia: an overlooked contribution. Mucosal Immunol. 2021;14(6):1224-1234.
  13. Ye Z, Huang Y, Liu D, Chen X, Wang D, Huang D, et al. Obesity induced by neonatal overfeeding worsens airway hyperresponsiveness and inflammation. PLoS One. 2012;7(10):e47013.
  14. Mancuso P. Obesity and lung inflammation. J Appl Physiol. 2010;108(3):722-728.
  15. Arias-Bravo G, Valderrama G, Inostroza J, Reyes-Farías M, Garcia-Diaz DF, Zorondo-Rodríguez F, et al. Overnutrition in Infants Is Associated With High Level of Leptin, Viral Coinfection and Increased Severity of Respiratory Infections: A Cross-Sectional Study. Front Pediatr. 2020;8:44.
  16. Mafort TT, Rufino R, Costa CH, Lopes AJ. Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function. Multidiscip Respir Med. 2016;11:28.
  17. Bramley AM, Reed C, Finelli L, Self WH, Ampofo K, Arnold SR, et al. Centers for Disease Control and Prevention Etiology of Pneumonia in the Community (EPIC) Study Team. Relationship Between Body Mass Index and Outcomes Among Hospitalized Patients With Community-Acquired Pneumonia. J Infect Dis. 2017 Jun 15;215(12):1873-1882.
  18. Murillo-Zamora E, Aguilar-Sollano F, Delgado-Enciso I, Hernandez-Suarez CM. Predictors of laboratory-positive COVID-19 in children and teenagers. Public Health. 2020;189(1):153-157.
  19. Jha S, Mehendale AM. Increased Incidence of Obesity in Children and Adolescents Post-COVID-19 Pandemic: A Review Article. Cureus. 2022;14(9):e29348.
  20. La Fauci G, Montalti M, Di Valerio Z, Gori D, Salomoni MG, Salussolia A, et al. Obesity and COVID-19 in Children and Adolescents: Reciprocal Detrimental Influence-Systematic Literature Review and Meta-Analysis. Int J Environ Res Public Health. 2022;19(13):7603.
  21. Hauerslev M, Narang T, Gray N, Samuels TA, Bhutta ZA. Childhood obesity on the rise during COVID-19: A request for global leaders to change the trajectory. Obesity (Silver Spring). 2022;30(2):288-291.
  22. Karlsson EA, Meliopoulos VA, van de Velde NC, van de Velde LA, Mann B, Gao G, et al. A Perfect Storm: Increased Colonization and Failure of Vaccination Leads to Severe Secondary Bacterial Infection in Influenza Virus-Infected Obese Mice. mBio. 2017;8(5):e00889-17.
  23. Gerhart JG, Balevic S, Sinha J, Perrin EM, Wang J, Edginton AN, et al. Characterizing Pharmacokinetics in Children With Obesity-Physiological, Drug, Patient, and Methodological Considerations. Front Pharmacol. 2022;13(1):818726.
  24. Kyler KE, Wagner J, Hosey-Cojocari C, Watt K, Shakhnovich V. Drug Dose Selection in Pediatric Obesity: Available Information for the Most Commonly Prescribed Drugs to Children. Paediatr Drugs. 2019;21(5):357-369.
  25. Gaeta F, Conti V, Pepe A, Vajro P, Filippelli A, Mandato C. Drug dosing in children with obesity: a narrative updated review. Ital J Pediatr. 2022;48(1):168.
  26. Kyler KE, Wagner J, Hosey-Cojocari C, Watt K, Shakhnovich V. Drug Dose Selection in Pediatric Obesity: Available Information for the Most Commonly Prescribed Drugs to Children. Paediatr Drugs. 2019;21(5):357-369.
  27. Prabawa IMY, Silakarma D, Prabawa IPY, Manuaba IBAP. Physical rehabilitation therapy for long covid-19 patient with respiratory sequelae: A systematic review. Open Access Macedonian Journal of Medical Sciences. 2022;10(F):468-474.
  28. Usman MR, Wati DK, Subanada IB. The outcome of antibiotic therapy among children with severe community-acquired pneumonia. Bali Medical Journal. 2015;4(2):89–92.
  29. Adinatha Y, Subanada IB, Arimbawa IM, Nilawati GAP, Gunawijaya E, Hartawan INB. The effectiveness of probiotics as adjuvant therapy for severe pneumonia in children below 5 years old at Sanglah General Hospital, Bali, Indonesia. Bali Medical Journal. 2020;9(1):390–394.
  30. Arief F, Setyoningrum RA, Irawan R, Husada D, Utamayasa IKA, Kahar H. Vitamin D and cathelicidin assessment in children with pneumonia. Bali Medical Journal. 2023;12(1):235–238.

How to Cite

Mayangsari, A. S. M. (2023). Unique problems of pneumonia in obese children: a literature review. Intisari Sains Medis, 14(2), 691–695.




Search Panel

Ayu Setyorini Mestika Mayangsari
Google Scholar
ISM Journal