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Odds of COVID-19-associated asthma exacerbations in children higher during Omicron wave
Kristina Gaietto1,2, Nicholas Bergum2, Franziska Rosser1,2
1Department of Pediatrics, Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Insights
The Omicron variant wave saw a significant increase in asthma exacerbations among children with asthma during COVID-19 infections. This highlights how different COVID-19 variants impact respiratory symptoms and supports vaccination efforts.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Epidemiology
Background:
- Asthma exacerbations in children are a significant public health concern.
- The emergence of SARS-CoV-2 variants has altered the landscape of COVID-19.
- Understanding variant-specific impacts on chronic respiratory conditions is crucial.
Purpose of the Study:
- To investigate the association between COVID-19 variant waves and asthma exacerbations in pediatric asthma patients.
- To compare the rates of asthma exacerbations during the Pre-Delta, Delta, and Omicron variant waves of COVID-19.
Main Methods:
- Retrospective cross-sectional study utilizing the Western Pennsylvania COVID-19 Registry (WPACR).
- Data extracted for children with asthma, comparing outcomes across Pre-Delta, Delta, and Omicron waves.
- Multivariable logistic regression analyses were performed to assess SARS-CoV-2-associated asthma exacerbations.
Main Results:
- The Omicron wave showed a higher proportion of asthma exacerbations (40.2%) compared to prior waves (22.6% and 26.2%).
- Multivariable models indicated 2.8 times higher odds of asthma exacerbation during the Omicron wave.
- Adjusting for asthma severity did not alter significance, but adjusting for poor asthma control did.
Conclusions:
- Asthma exacerbations during SARS-CoV-2 infection were more frequent during the Omicron variant wave.
- COVID-19 symptoms and impacts vary significantly by variant.
- Findings reinforce the importance of vaccination and preventative measures for children with asthma.
Background:
We aimed to determine the association of COVID-19 variant wave with asthma exacerbations in children with asthma.
Methods:
We conducted a retrospective cross-sectional study of children in the Western Pennsylvania COVID-19 Registry (WPACR). We extracted data for all children in the WPACR with asthma and compared their acute clinical presentation and outcomes during the Pre-Delta (7/1/20-6/30/21), Delta (8/1/21-12/14/21), and Omicron (12/15/21-8/30/22) waves. We conducted multivariable logistic regression analyses of SARS-CoV-2-associated asthma exacerbations, adjusting for characteristics that have been associated with COVID-19 outcomes in prior studies.
Results:
Among 573 children with asthma in the WPACR during the study period, the proportion of children with COVID-19 who had an asthma exacerbation was higher during the Omicron wave than during the prior two variant waves (40.2% vs. 22.6% vs. 26.2%, p = 0.002; unadjusted OR = 2.12 [95% confidence interval (CI) = 1.39-3.22], p < 0.001). In our multivariable regression models, the odds of an asthma exacerbation were 2.8 times higher during the Omicron wave than during prior waves (adjusted OR = 2.80 [95% CI = 1.70-4.61]). Results were similar after additionally adjusting for asthma severity but were no longer significant after additionally adjusting for poor asthma control.
Conclusion:
The proportion of children with asthma experiencing an asthma exacerbation during SARS-CoV-2 infection was higher during Omicron than prior variant waves, adding to the body of evidence that COVID-19-associated respiratory symptoms vary by variant. These findings provide additional support for vaccination and prevention.
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