COVID-19 in a group of children with asthma: presentation, severity, and outcome

Zeineb A El-Sayed; Rasha H El-Owaidy; Waleed N Harb; Ghada A Shousha

COVID-19 in a group of children with asthma: presentation, severity, and outcome

Am J Clin Exp Immunol. 2022 Dec 15;11(6):92-102. eCollection 2022.

Authors

Zeineb A El-Sayed¹, Rasha H El-Owaidy¹, Waleed N Harb², Ghada A Shousha¹

Affiliations

¹ Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University Cairo, Egypt.
² Fever Hospital of Al-Mahalla Al-Kubra Al-Gharbya Governate, Egypt.

PMID: 36660141
PMCID: PMC9845840

Abstract

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.

Keywords: Bronchial asthma; CO-RAD; COVID-19; children.