Comparison of clinical features of COVID‐19 infection in children with asthma and their healthy peers

Abstract

Aim We aimed to assess the impact of COVID‐19 on asthma exacerbations and to compare the severity of symptoms of SARS‐CoV‐2 infection of asthmatic children with those of healthy children. Methods The clinical course of COVID‐19 was compared among 89 children with asthma and 84 healthy children with age‐ and gender‐matched. Demographic factors, severity of asthma, duration of asthma, presence of atopy, type of treatment, and compliance to treatment in asthmatic children on clinical course of infection and to determine the risk factors for severe course for asthma exacerbation during COVID‐19 were evaluated retrospectively. Demographic characteristics, clinical symptoms, duration of complaints, and hospitalization rates were statistically compared between the two groups. Results Both groups had similar rates of symptomatic disease, hospitalization, and duration of fever. Among children with asthma mean age was 10.3 years, 59.6% were male, and 84.3% had mild asthma. Dyspnea was more prevalent in asthmatic children ( p :0.012), but other clinical findings were not different from those of healthy controls. 12.4% ( n :11) of asthmatic children had asthma exacerbation, 2.2% ( n :2) of them were hospitalized; one (1.1%) of which was due to asthma exacerbation. Conclusion The course of COVID‐19 in patients with mild to moderate asthma, who were followed up regularly and who were compliant with their treatment, was similar to their healthy peers. Since there was no severe asthma case in our study, the results could not have been generalized to all asthmatic patients. Further comprehensive and multicenter studies are required in pediatric population.

Management of patients with allergic diseases in the era of COVID-19

“…In the early stages of the COVID-19 pandemic, the effect of asthma on COVID-19 severity in children was examined in small studies, partially because of the lower prevalence of COVID-19 in children. 16) Whether asthma is a risk factor for COVID-19-associated hospitalization or severe COVID-19 remains controversial. Some studies have reported that asthma is not a risk factor for severe COVID-19 (Table 2).…”

“…Some studies have reported that asthma is not a risk factor for severe COVID-19 (Table 2). 16,17) However, others reported that children (12-17 years) with asthma are at higher risk of requiring hospitalization for COVID-19. 18) It has also reported that COVID-19 patients aged ≥16 years with asthma are more likely to require critical care (adjusted odds ratio [aOR], 1.20; 95% confidence interval [CI], 1.05-1.37), noninvasive ventilation (aOR, 1.36; 95% CI, 1.18-1.57), and oxygen supplementation (aOR, 1.33; 95% CI, 1.17-1.50) than those without asthma.…”

“…Because the prevalence of severe asthma in children is relatively low compared with that in adults, 20) few studies have reported the A c c e p t e d A r t i c l e effects of severe asthma on the clinical outcomes of COVID-19 in adolescents. Children aged [12][13][14][15][16][17] years with asthma prescribed one (adjusted hazard ratio [aHR], 2.58; 95% CI, 1.82-3.66) or two or more (aHR, 3.80, ; 95% CI, 2.41-5.95) courses of oral corticosteroids in the year preceding the COVID-19 pandemic were reportedly at greater risk of COVID-19-related hospitalization. 18) In adults, uncontrolled asthma (OR, 1.64; 95% CI, 1.35-2.00) and the requirement of higher amounts of asthma medications, such as high-dose inhaled corticosteroid (ICS) combined with long-acting β-agonists (OR, 1.40; 95% CI, 1.22-1.60), was associated with severe COVID-19.…”

“…Whether asthma is a risk factor for COVID-19-associated hospitalization or severe COVID-19 remains controversial. Some studies have reported that asthma is not a risk factor for severe COVID-19 ( Table 2 ) [ 16 , 17 ]. However, others reported that children (12–17 years) with asthma are at higher risk of requiring hospitalization for COVID-19 [ 18 ].…”

The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil

“…For instance, some studies have shown poorer outcomes in children and adults with asthma 6,8,9 whereas others have detected a protective effect of asthma both for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and COVID‐19‐related death 10–12 . Therefore, the relationship between COVID‐19 and asthma is still unclear 13,14 . Moreover, in the pediatric setting, most studies are from high‐income countries, often with a small sample size, which may limit the generalizability of findings 15–17 …”