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Asthma and COVID-19 in children: A systematic review and call for data
Jose A Castro-Rodriguez1, Erick Forno2
1Department of Pediatric Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Insights
Limited data exists on childhood asthma as a risk factor for COVID-19. Further research is needed to understand the association between pediatric asthma and coronavirus disease 2019 (COVID-19) risk and severity.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Epidemiology
Background:
- Asthma is a common chronic respiratory disease in children.
- The relationship between pediatric asthma and coronavirus disease 2019 (COVID-19) risk or severity remains unclear.
- Understanding this association is crucial for managing pediatric respiratory health during the pandemic.
Purpose of the Study:
- To systematically assess the available literature on pediatric asthma as a risk factor for COVID-19.
- To determine if children with asthma have a higher risk of contracting COVID-19 or experiencing severe illness.
- To identify gaps in current research regarding pediatric asthma and COVID-19.
Main Methods:
- A three-stage systematic literature search was conducted across multiple databases (PubMed, EMBASE, CINAHL) and preprint servers (BioRxiv, MedRxiv).
- The search focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 in pediatric populations, specifically examining studies that included data on asthma or wheeze.
- Primary articles from relevant systematic reviews were also evaluated.
Main Results:
- No studies directly addressed pediatric asthma as a comorbidity for COVID-19 in the initial systematic review of pediatric COVID-19 literature.
- Searches for COVID-19 and asthma yielded studies primarily on adults, with no specific data on children.
- Limited reports indicated the presence of asthma in a subset of hospitalized pediatric COVID-19 cases, but comprehensive data is lacking.
Conclusions:
- There is a significant lack of data on the role of childhood asthma in COVID-19 infection risk and severity.
- Existing research does not adequately address pediatric respiratory diseases, including asthma, as potential risk factors for SARS-CoV-2.
- Future studies should focus on collecting specific data on pediatric asthma and its impact on COVID-19 outcomes.
Rationale:
Whether asthma constitutes a risk factor for coronavirus disease-2019 (COVID-19) is unclear. Here, we aimed to assess whether asthma, the most common chronic disease in children, is associated with higher COVID-19 risk or severity in pediatric populations.
Methods:
We performed a systematic literature search in three stages: first, we reviewed PubMed, EMBASE, and CINAHL for systematic reviews of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 in pediatric populations, and reviewed their primary articles; second, we searched PubMed for studies on COVID-19 or SARS-CoV-2 and asthma/wheeze, and evaluated whether the resulting studies included pediatric populations; third, we repeated the second search in BioRxiv.org and MedRxiv.org to find pre-prints that may have information on pediatric asthma.
Results:
In the first search, eight systematic reviews were found, of which five were done in pediatric populations; none of the 67 primary studies included data on pediatric asthma as a comorbidity for COVID-19. In the second search, we found 34 results in PubMed, of which five reported asthma in adults, but none included data on children. In the third search, 25 pre-prints in MedRxiv included data on asthma, but none on children. We found one report by the US Centers for Disease Control and Prevention stating that 40/345 (~11.5%) children with data on chronic conditions had "chronic lung diseases including asthma," and one from a tertiary hospital in New York that reported asthma in 11/46 (~23.9%) children hospitalized for COVID-19.
Conclusion:
There is scarcely any data on whether childhood asthma (or other pediatric respiratory diseases) constitute risk factors for SARS-CoV-2 infection or COVID-19 severity. Studies are needed that go beyond counting the number of cases in the pediatric age range.
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