Chen-Yuan Chiang1,2,3, Philippa Ellwood4, Eamon Ellwood4, Luis García-Marcos5,6, Refiloe Masekela7, Innes Asher4, Héctor Badellino8, Alberto Bercedo Sanz9, Konstantinos Douros10, Asma El Sony11, Carlos González Diaz12,13, Ms Albi Rodríguez14, Ana Moreno-Salvador15, Luis F Pérez-Martini16, Nelson Rosário Filho17, Andrei Shpakou18, Shairbek Sulaimanov19, Marzieh Tavakol20, José Valverde-Molina21, Abdullah A Yousef22,23, Neil Pearce24. 1. International Union Against Tuberculosis and Lung Disease, Paris, France. 2. Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 3. Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Department of Paediatrics, Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 5. Pediatric Allergy and Pulmonology Units, Virgen de la Arrixaca University Children's Hospital, University of Murcia and IMIB Bioresearch Institute, Murcia, Spain. 6. ARADyAL Allergy Network, Edificio Departamental-Laib, El Palmar, Murcia, Spain. 7. Department of Paediatrics and Child Health, Nelson R Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa. 8. Pediatric Respiratory Medicine Department, UCES University and Clínica Regional del Este, Corrientes, San Francisco, Argentina. 9. Cantabrian Health Service, Valdecilla Research Institute (IDIVAL), Dobra Health Center, Torrelavega, Cantabria, Spain. 10. School of Medicine, 3rd Department of Pediatrics, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece. 11. Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum, Sudan. 12. Department of Pediatrics, University of the Basque Country, Bilbao, Vizcaya, Spain. 13. UPV/EHU, Basurto University Hospital, Bilbao, Vizcaya, Spain. 14. Pediatric Pneumology and Allergy Unit, Hospital Universitario Doce de Octubre, Madrid, Spain. 15. Pediatric Allergy Unit, Virgen de la Arrixaca University Children's Hospital, University of Murcia, Spain. 16. Asociación Guatemalteca de Neumología y Cirugía de Tórax, Guatemala, Ciudad, Guatemala. 17. Hospital de Clinicas, Federal University of Parana, Curitiba, Parana, Brasil. 18. Department of Theory of Physical Culture and Sport Medicine, Yanka Kupala State University of Grodno, Grodno, Belarus. 19. Kyrgyz-Russian Slavic University, Bishkek City, Kyrgyzstan. 20. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. 21. Department of Pediatrics, Hospital General Universitario Santa Lucia, Cartagena, Murcia, Spain. 22. College of Medicine, Imam Abdulrahman bin Faisal University, Al Khobar, Saudi Arabia. 23. Department of Pediatrics, King Fahd Hospital of the University Alkhobar, Al Khobar, Saudi Arabia. 24. Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
Abstract
BACKGROUND: Clinical presentations of coronavirus disease 2019 (COVID-19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID-19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest. METHODS: The Global Asthma Network (GAN) conducted a global survey among GAN centers. Data collection was between November 2020 and April 2021. RESULTS: Fourteen GAN centers from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%), and severe/critical in 4 (2.4%). Thirty-eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3-16). Those who had moderate or more severe COVID-19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID-19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23-12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02-5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regard to being symptomatic, severity of COVID-19, asthma exacerbation, and hospitalization. CONCLUSIONS: Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID-19.
BACKGROUND: Clinical presentations of coronavirus disease 2019 (COVID-19) among children with asthma have rarely been investigated. This study aimed to assess clinical manifestations and outcome of COVID-19 among children with asthma, and whether the use of asthma medications was associated with outcomes of interest. METHODS: The Global Asthma Network (GAN) conducted a global survey among GAN centers. Data collection was between November 2020 and April 2021. RESULTS: Fourteen GAN centers from 10 countries provided data on 169 children with asthma infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was asymptomatic in 58 (34.3%), mild in 93 (55.0%), moderate in 14 (8.3%), and severe/critical in 4 (2.4%). Thirty-eight (22.5%) patients had exacerbation of asthma and 21 (12.4%) were hospitalized for a median of 7 days (interquartile range 3-16). Those who had moderate or more severe COVID-19 were significantly more likely to have exacerbation of asthma as compared to those who were asymptomatic or had mild COVID-19 (adjusted odds ratio (adjOR) 3.97, 95% CI 1.23-12.84). Those who used inhaled bronchodilators were significantly more likely to have a change of asthma medications (adjOR 2.39, 95% CI 1.02-5.63) compared to those who did not. Children who used inhaled corticosteroids (ICS) did not differ from those who did not use ICS with regard to being symptomatic, severity of COVID-19, asthma exacerbation, and hospitalization. CONCLUSIONS: Over dependence on inhaled bronchodilator may be inappropriate. Use of ICS may be safe and should be continued in children with asthma during the pandemic of COVID-19.
Authors: Andrei Shpakou; Elżbieta Krajewska-Kułak; Mateusz Cybulski; Izabela Seredocha; Anna Tałaj; Małgorzata Andryszczyk; Ewa Kleszczewska; Anna Szafranek; Beata Modzelewska; Ihar A Naumau; Andrei Tarasov; Ludmila Perminova; Rafał Modzelewski Journal: Int J Environ Res Public Health Date: 2022-08-18 Impact factor: 4.614