Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study

Petrea (Cliveți), Carmen Loredana; Ciortea, Diana-Andreea; Gurău, Gabriela; Matei, Mădălina Nicoleta; Barbu, Codrina; Verga (Răuță), Gabriela Isabela; Lungu, Irinel; Vălcan, Mariana Mirela; Berbece, Sorin Ion

doi:10.3390/nu18172793

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Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study

by

Carmen Loredana Petrea (Cliveți)

^1,2

,

Diana-Andreea Ciortea

^1,3,*

,

Gabriela Gurău

^1,2,†

,

Mădălina Nicoleta Matei

^1,2,*,

Codrina Barbu

^1,2,‡,

Gabriela Isabela Verga (Răuță)

^1,2,‡

,

Irinel Lungu

^1,2,

Mariana Mirela Vălcan

^4,‡

and

Sorin Ion Berbece

^1,†

¹

Research Center in the Medico-Pharmaceutical Field, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, 800008 Galati, Romania

²

“Sf. Ioan” Emergency Clinical Hospital for Children, 800487 Galati, Romania

³

“Maria Sklodowska Curie” Emergency Clinical Hospital for Children, 041451 Bucharest, Romania

⁴

Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

^‡

These authors also contributed equally to this work.

Nutrients 2026, 18(17), 2793; https://doi.org/10.3390/nu18172793

Submission received: 13 July 2026 / Revised: 20 August 2026 / Accepted: 22 August 2026 / Published: 26 August 2026

(This article belongs to the Section Pediatric Nutrition)

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Abstract

Background/Objectives: Nutritional, inflammatory, and lifestyle-related characteristics may contribute to substantial biological heterogeneity among children with documented previous SARS-CoV-2 infection. This study aimed to characterize an integrated nutritional-inflammatory profile and explore its relationships with biological and clinical features in a hospitalized pediatric cohort. Methods: This retrospective cohort study included 260 children with documented previous SARS-CoV-2 infection. Clinical, anthropometric, and laboratory data were complemented by questionnaire-derived dietary and lifestyle information (n = 213). Analyses combined conventional statistics with correlation and multivariate techniques, including PCA and K-means clustering (n = 231) and exploratory Ridge regression (n = 188). Results: Suboptimal serum 25(OH)D concentrations (<30 ng/mL) were present in 55.8% of participants (95% CI [49.7%, 61.7%]), while 43.5% were overweight or obese (95% CI [37.6%, 49.5%]). BMI correlated with hemoglobin (ρ = 0.23) and CRP (ρ = 0.12), while 25(OH)D correlated with potassium (ρ = 0.22). Increasing daily device use was associated with progressively lower 25(OH)D concentrations (H = 24, p < 0.001, ε² = 0.11), with median values decreasing from 33 ng/mL at <1 h/day to 24 ng/mL at >4 h/day. PCA identified three complementary biological dimensions explaining 55.0% of the total variance, while K-means clustering identified three reproducible exploratory nutritional–inflammatory phenotypes differentiated by age, BMI, hematological and inflammatory characteristics, and selected lifestyle factors. Conclusions: The findings show multidimensional nutritional–inflammatory heterogeneity in children with documented previous SARS-CoV-2 infection. The identified patterns and exploratory phenotypes provide an integrated framework for biological characterization and warrant validation in prospective multicenter cohorts.

Keywords: previous SARS-CoV-2 infection; children; nutritional-inflammatory profile; 25-hydroxyvitamin D; inflammatory biomarkers; principal component analysis; lifestyle; exploratory phenotypes

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MDPI and ACS Style

Petrea, C.L.; Ciortea, D.-A.; Gurău, G.; Matei, M.N.; Barbu, C.; Verga, G.I.; Lungu, I.; Vălcan, M.M.; Berbece, S.I. Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study. Nutrients 2026, 18, 2793. https://doi.org/10.3390/nu18172793

AMA Style

Petrea CL, Ciortea D-A, Gurău G, Matei MN, Barbu C, Verga GI, Lungu I, Vălcan MM, Berbece SI. Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study. Nutrients. 2026; 18(17):2793. https://doi.org/10.3390/nu18172793

Chicago/Turabian Style

Petrea (Cliveți), Carmen Loredana, Diana-Andreea Ciortea, Gabriela Gurău, Mădălina Nicoleta Matei, Codrina Barbu, Gabriela Isabela Verga (Răuță), Irinel Lungu, Mariana Mirela Vălcan, and Sorin Ion Berbece. 2026. "Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study" Nutrients 18, no. 17: 2793. https://doi.org/10.3390/nu18172793

APA Style

Petrea, C. L., Ciortea, D.-A., Gurău, G., Matei, M. N., Barbu, C., Verga, G. I., Lungu, I., Vălcan, M. M., & Berbece, S. I. (2026). Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study. Nutrients, 18(17), 2793. https://doi.org/10.3390/nu18172793

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Associations and Multidimensional Characterization of the Nutritional-Inflammatory Profile in Children with Previous SARS-CoV-2 Infection: A Retrospective Cohort Study

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