Covid-19-positive children with asthma visited the ED more often for their asthma than children who tested negative for SARS-CoV-2, according to a study reported in the Journal of Allergy and Clinical Immunology. They were also hospitalized more frequently and required more steroids to control their asthma.¹

A total of 61,916 children with asthma, aged 2-17.9 years, from the Cerner Real-World Data were enrolled for the present study. These children had undergone a RT PCR for Covid-19 between March 2020 and February 2021. Control of asthma was assessed on the basis of prescription refill rates for oral steroids and SABA, emergency room visits and hospitalizations per 1,000 patients every 6 months.

Asthmatic children who also tested positive for Covid-19 had a significant increase in ED visits with frequency ratio (IRR) 1.17; they also refilled their oral steroid prescriptions more often (IRR 1.23) during the 6 months after their test. A small increase in hospitalizations (IRR 1.13) and use of SABAs (IRR 1.02) was also seen. But children who tested negative for the virus had fewer asthma-related hospitalizations, ED visits, OCS fill rates and SABA use in the 6 months after their test indicating improved asthma control.

No significant differences in ED, hospitalizations or SABA fill rates were noted in the six months prior to the PCR test regardless of their Covid status, whether positive or negative. Though Covid-positive children showed a small reduction in use of oral steroids compared to Covid-negative children.

This study demonstrates that children with asthma and who had Covid-19 had poor control of their asthma within six months of infection. According to the authors, their shows "longer lasting harm of COVID on childrens asthma control."

This is the first large-scale nationwide study demonstrating a worsening of asthma 23 outcomes in children during the six months following a PCR-confirmed COVID-19 infection. Our data demonstrates that while asthma outcomes were again improved for those who tested negative for SARS-COV-2 PCR, asthmatic children who were definitively diagnosed with COVID-19 have worse asthma control in the first six months after infection.

Reference

1. Chou CC, et al. COVID-19 infection may trigger poor asthma control in children. J Allergy Clin Immunol Pract. 2022 Apr 26: S2213-2198(22)00360-9.