Malnutrition and anaemia associated with severe Covid in infants: BJMC study

The study findings, published in the Journal of Tropical Paediatrics, shows how infants who had a severe form of the disease also had comorbidities.

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A significant finding was that some infants suffered from malnutrition and anaemia, some had sickle cell anaemia and some had congenital anomalies,” said Dr Kinikar. (Photo: Getty Images/Thinkstock)

Malnutrition and anaemia are associated with severe Covid in infants, according to a new study by researchers from the B J Medical College and Sassoon General Hospital in Pune. The study findings, published in the Journal of Tropical Paediatrics, shows how infants who had a severe form of the disease also had comorbidities.

From March till date, the Sassoon General Hospital has registered a total of 384 critically ill children (from neonates till 12 year olds). Of these, 105 children were Covid positive and nearly 80 per cent required ICU care. There were two deaths – one of an 11-year-old who was Covid positive and suffered from chronic kidney disease, with multi-organ dysfunction, while the second patient was a baby who was Covid positive and also suffered from severe malnutrition with haemoglobin levels of less than one gram per cent.

In the current study, a total of 13 infants admitted at Sassoon General Hospital, who tested positive for Covid-19 between April and August this year, were included. Nine were male, and the youngest infant was aged 3 months and the oldest was 13 months old. They all exhibited some common symtopms like fever, poor feeding, irritability, and runny nose.

In three of the cases, the infants with severe Covid-19 also had the comorbidity of severe acute malnutrition (SAM), Dr Aarti Kinikar, professor and head of the Department of Paediatrics, B J Medical College and Sassoon General Hospital, told The Indian Express.

“Our study focussed exclusively on infants with Covid-19. Nine of our cases had co-morbidities, of which four developed a severe form of the disease. A significant finding was that some infants suffered from malnutrition and anaemia, some had sickle cell anaemia and some had congenital anomalies,” said Dr Kinikar.

While it is known that Covid-19 is less common in children, including infants, researchers said this could also be due to a lower risk of exposure or incomplete identification due to mild or asymptomatic disease, rather than resistance to infection. “We can’t say that Covid-19 is not serious in children,” said Dr Kinikar.

Studies from Europe have shown that majority of infants have a mild form of the disease, while infants with comorbidities may have a higher risk of severe disease.

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In India, this study is among the first ones that show malnutrition and anaemia are associated with severe Covid in infants. Dr Kinikar said that the study was significant as the findings of the fifth round of the National Family Health Survey (NFHS), released last week, show a substantial rise in malnutrition and anaemia.

“Compared to the developed world, India still has a huge burden of severe malnutrition and anemia in children.The mortality in our case series occurred in a severely malnourished child, who also had severe megaloblastic anaemia,” said Dr Kinikar.

According to the NFHS 2019-20 data, more than 50 per cent of children and women were found to be anaemic in 13 states and union territories. Maharashtra is among the states that have registered a jump in the percentage of stunted children under five years of age, in comparison to NFHS 2015-16.

A recent report in The Lancet had also pointed out that one in 10 deaths among children younger than 5 years in low and middle-income countries is attributable to severe wasting because wasted children are at increased risk of mortality from infectious diseases.

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Before the Covid-19 pandemic, an estimated 47 million children younger than 5 years were moderately or severely wasted across the world, most of them living in sub-Saharan Africa and south Asia.

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More

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