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COVID-19 in a group of children with asthma: presentation, severity, and outcome
Zeineb A El-Sayed1, Rasha H El-Owaidy1, Waleed N Harb2
1Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University Cairo, Egypt.
Insights
Childhood asthma did not significantly impact COVID-19 severity or outcomes in a small study. Further research is needed to confirm these findings and explore asthma treatments.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Clinical Immunology
Background:
- Limited data exist on COVID-19 severity in children with asthma.
- Understanding asthma's role in pediatric COVID-19 is crucial for clinical management.
Purpose of the Study:
- To evaluate the impact of asthma on the severity and outcomes of COVID-19 in children.
- To compare clinical presentations and laboratory findings between asthmatic and non-asthmatic pediatric COVID-19 patients.
Main Methods:
- An observational study involving 62 children (6-18 years) with confirmed/probable COVID-19.
- Two matched groups: 30 with asthma and 32 without asthma.
- Comparison of clinical, laboratory, and radiological data, severity, and outcomes based on GINA 2020 asthma guidelines.
Main Results:
- Wheezing was more frequent in asthmatic COVID-19 patients (p=0.001).
- Asthmatic children showed higher frequencies of elevated serum ferritin, LDH, and D-dimer.
- Despite differences in CO-RAD scores, COVID-19 severity, outcome, and hospital stay duration were comparable between groups (p>0.05).
Conclusions:
- Childhood asthma did not significantly affect COVID-19 severity or outcomes in this study.
- Further longitudinal research is recommended to validate findings and explore the influence of asthma treatments like immunotherapy and biologics.
Background:
There are insufficient data concerning COVID-19 severity among asthmatic children.
Aim:
to evaluate the impact of asthma on COVID-19 severity and outcome.
Patients And Methods:
We carried out an observational study that comprised 2 matched groups of children with confirmed/probable COVID-19: 30 with and 32 without asthma aged 6-18 years, who were enrolled consecutively from Children's Hospital, Ain Shams University, Egypt. COVID-19 clinical presentations, laboratory and radiological abnormalities, severity and outcome were compared between the 2 groups. Asthma severity and control were assessed based on GINA 2020.
Results:
The asthmatic COVID-19 children were 9 boys and 21 girls, with median age 9 years, IQR: 8-12 years. The non-asthmatic COVID-19 group included 18 males and 14 females with median age 9.5 years, IQR: 7-12.5 years. Clinical manifestations of COVID-19 were comparable among the 2 groups, except for wheezes which were more frequently encountered as a COVID-19 manifestation among the asthmatics (p=0.001). Multisystem inflammatory syndrome (MIS-c) was diagnosed in one asthmatic and 3 non-asthmatic patients. The asthmatic group had higher frequency of serum ferritin, LDH and D-dimer elevations compared to the non-asthmatic peers (p values 0.014, 0.001, and 0.015 respectively). Based on CO-RAD classification, 70% of the asthmatic patients had CO-RAD score of 5 versus 6.3 % among the non-asthmatic group with significant differences between the 2 groups in their CO-RAD scores (P=0.002). COVID-19 severity was comparable among the studied groups (P=0.775), as well as COVID-19 outcome and duration of hospital stay (p values 0.999, and 0.655, respectively).
Conclusion:
From our limited sample sized study, childhood asthma did not pose a significant impact on COVID-19 severity and outcome. Further longitudinal studies are warranted to validate our conclusion and investigate the relation of COVID-19 severity and outcome to allergen immunotherapy and the use of biologicals for asthma treatment.
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