Obesity is a risk factor for decrease in lung function after COVID-19 infection in children with asthma
Elif Soyak Aytekin1, Umit M Sahiner1, Sevda Tuten Dal1
1Department of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.
Insights
COVID-19 infection can cause small airway dysfunction in children with asthma. Obesity is a key risk factor for this decline, highlighting the need for monitoring these children long-term.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Asthma Research
Background:
- Asthma is a common childhood chronic disease.
- The impact of SARS-CoV-2 (the virus causing COVID-19) on pediatric asthma patients' lung function remains unclear.
- Understanding these effects is crucial for managing respiratory health in children.
Purpose of the Study:
- To investigate the clinical course and consequences of COVID-19 in children with asthma.
- To identify risk factors associated with decreased lung function tests (LFTs) post-COVID-19 infection.
- To evaluate the specific effects of SARS-CoV-2 on lung function in pediatric asthma patients.
Main Methods:
- A retrospective study comparing asthmatic children with and without COVID-19.
- Analysis of clinical data and lung function tests (LFTs) before and after COVID-19 infection.
- Identification of independent risk factors for significant decline in specific LFT parameters.
Main Results:
- 189 asthmatic children with COVID-19 and 792 without were analyzed.
- Most COVID-19 cases were mild (87.6%); severe outcomes like MIS-C and pneumothorax were rare.
- While overall LFTs (FEV1%, FVC%, FEV1/FVC) showed no significant change, FEF25%-75% significantly decreased post-COVID-19.
- Obesity and a family history of atopy were identified as independent risk factors for a ≥25% decrease in FEF25-75.
Conclusions:
- COVID-19 infection can lead to small airway dysfunction in children with asthma.
- Obesity is a significant independent risk factor for reduced small airway function after COVID-19.
- Long-term monitoring of small airway function is essential for asthmatic children post-COVID-19 infection.
Introduction:
It is not clear whether asthma, the most frequent chronic disease in childhood, is a risk for severe SARS-CoV-2 infection in the pediatric population and how SARS-CoV-2 infection affects the lung functions in these patients.
Purpose:
We aimed to investigate the course and the consequences of SARS-CoV-2 infection among children with asthma and determine the risk factors for the decline in lung function tests (LFTs).
Methods:
In this retrospective study, asthmatic children with coronavirus disease 2019 (COVID-19) were compared with a random control group of asthmatic patients without COVID-19. In addition, the clinical course and the effect on LFTs of COVID-19 among children with asthma were also evaluated.
Results:
One hundred eighty-nine patients who had COVID-19, and 792 who did not were included in the study. Fever, fatigue, and cough were the most frequent symptoms during COVID-19. Regarding the severity of COVID-19, 163 patients (87.6%) had a mild clinical condition, 13 (7%) had moderate disease, 1 (0.5%) had severe disease, and 2 had (1.1%) critically ill disease. Two patients were diagnosed with multisystem inflammatory syndrome in children (MIS-C), one patient suffered from pneumothorax. LFTs of the patients before and after COVID-19 infection were analyzed; no significant differences were found in FEV1 % (91.7% vs. 90.9%, p = 0.513), FVC% (89.8% vs. 90.8%, p = 0.502) and FEV1 /FVC (103.1% vs. 100.6%, p = 0.056), while FEF25%-75% values (107.6% vs. 98.4%, p < 0.001) were significantly lower after the COVID-19 infection. Obesity (odds ratio [OR]: 3.785, 95% confidence interval [CI]: 1.152-12.429, p = 0.028] and having a family history of atopy (OR: 3.359, 95% CI: 1.168-9.657, p = 0.025] were found to be the independent risk factors for ≥25% decrease in FEF25-75 after COVID-19 infection.
Conclusion:
COVID-19 infection leads to dysfunction of the small airways in asthmatic children and obesity is an independent risk factor for a ≥25% decrease in FEF25-75. The long-term effects of COVID-19 infection especially on small airways require close monitoring in children with asthma.
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