Asthma and the Risk of SARS-CoV-2 Infection Among Children and Adolescents

Abstract

OBJECTIVE Over 6 million pediatric SARS-CoV-2 infections have occurred in the United States, but risk factors for infection remain poorly defined. We sought to evaluate the association between asthma and SARS-CoV-2 infection risk among children. METHODS We conducted a retrospective cohort study of children 5 to 17 years of age receiving care through the Duke University Health System and who had a Durham County, NC residential address. Children were classified as having asthma using previously validated electronic health record-based definitions. SARS-CoV-2 infections were identified based on positive PCR testing of respiratory samples collected between March 1, 2020, and September 30, 2021. We matched children with asthma 1:1 to children without asthma using propensity scores and used Poisson regression to evaluate the association between asthma and SARS-CoV-2 infection risk. RESULTS Of 46,900 children, 6,324 (13.5%) met criteria for asthma. Children with asthma were more likely to be tested for SARS-CoV-2 infection than children without asthma (33.0% vs. 20.9%, p<0.0001). In a propensity score-matched cohort of 12,648 children, 706 (5.6%) children tested positive for SARS-CoV-2 infection, including 350 (2.8%) children with asthma and 356 (2.8%) children without asthma [risk ratio: 0.98, 95% confidence interval: 0.85-1.13]. There was no evidence of effect modification of this association by inhaled corticosteroid prescription, history of severe exacerbation, or comorbid atopic diseases. Only one child with asthma required hospitalization for SARS-CoV-2 infection. CONCLUSIONS After controlling for factors associated with SARS-CoV-2 testing, we found that children with asthma have a similar SARS-CoV-2 infection risk as children without asthma.

Impact of COVID-19 in Children with Chronic Lung Diseases

“…Such improved asthma control, probably due to reduced exposure to asthma triggers and increased treatment adherence, led by the fear of COVID-19, points out that asthma was not a risk factor for severe COVID-19. In keeping with this, a retrospective cohort study [ 12 ] in North Carolina found no evidence that asthma predisposes children to SARS-CoV-2 infection or severe illness from COVID-19. However, the level of asthma control is a key factor with respect to the risk of severe COVID-19.…”

Healthcare utilization in Canadian children and young adults with asthma during the COVID-19 pandemic

“…Table 1 shows that there were 716,690 children and young adults aged �25 years old with prevalent asthma in Ontario in 2019. Of these, 7.1% were pre-schoolers (0-4 years), 16.4% early school aged (5-9), 21.4% early teens (10)(11)(12)(13)(14), and 55.1% youths and young adults (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). The study cohort consisted of 41.9% females, largely from areas of middle to high income quintiles (63.4%), and the majority (92.5%) resided in urban areas.…”

“…There is limited literature examining the impact of the COVID-19 pandemic in children and young adults with asthma. While recent literature suggests improved asthma control during the pandemic, it has reported mixed results on whether individuals with asthma have greater susceptibility to COVID-19 [9][10][11][12]. Understanding how the pandemic has impacted asthma-related HSU and medication use, can provide insights into medication adherence, asthma symptom and exacerbation control during the pandemic.…”

New views on the diagnosis and treatment of asthma in children

“…For citation: Zdorov'e Rebenka. 2022;17 (2):107-113. doi: 10.22141/2224-0551.17. 2.2022.1503 Резюме.…”

“…Серед 12 648 дітей 706 (5,6 %) мали позитивний результат на інфекцію SARS-CoV-2, у тому числі 350 (2,8 %) дітей з астмою та 356 (2,8 %) дітей без астми (ВШ 0,98; 95% ДІ 0,85-1,13). Не було доказів змін цього зв'язку при призначенні інгаляційних кортикостероїдів, тяжкому загостренні в анамнезі або супутніх атопічних захворюваннях [14].…”