El-Sayed Zeineb A, El-Owaidy Rasha H, Harb Waleed N, Shousha Ghada A
Pediatric Allergy, Immunology and Rheumatology Unit, Children's Hospital, Ain Shams University Cairo, Egypt.
Fever Hospital of Al-Mahalla Al-Kubra Al-Gharbya Governate, Egypt.
Am J Clin Exp Immunol. 2022 Dec 15;11(6):92-102. eCollection 2022.
There are insufficient data concerning COVID-19 severity among asthmatic children.
to evaluate the impact of asthma on COVID-19 severity and outcome.
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.
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 ( 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 ( values 0.999, and 0.655, respectively).
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.
关于哮喘儿童感染新型冠状病毒肺炎（COVID-19）的严重程度，目前数据不足。
评估哮喘对COVID-19严重程度及预后的影响。
我们开展了一项观察性研究，纳入两组相匹配的确诊/疑似COVID-19儿童：30例患有哮喘，32例未患哮喘，年龄在6至18岁之间，均连续来自埃及艾因夏姆斯大学儿童医院。比较两组患者的COVID-19临床表现、实验室及影像学异常、严重程度及预后。根据2020年全球哮喘防治创议（GINA）评估哮喘的严重程度及控制情况。
患有COVID-19的哮喘儿童中，男性9例，女性21例，中位年龄9岁，四分位间距（IQR）：8至12岁。未患哮喘的COVID-19组包括18例男性和14例女性，中位年龄9.5岁，IQR：7至12.5岁。两组COVID-19的临床表现具有可比性，但喘息作为COVID-19的一种表现，在哮喘患者中更常见（p = 0.001）。1例哮喘患者和3例非哮喘患者被诊断为多系统炎症综合征（MIS-c）。与非哮喘同龄人相比，哮喘组血清铁蛋白、乳酸脱氢酶（LDH）和D-二聚体升高的频率更高（分别为0.014、0.001和0.015）。根据CO-RAD分类，70%的哮喘患者CO-RAD评分为5分，而非哮喘组为6.3%，两组CO-RAD评分存在显著差异（P = 0.002）。研究组之间的COVID-19严重程度具有可比性（P = 0.775），COVID-19预后及住院时间也具有可比性（分别为0.999和0.655）。
从我们样本量有限的研究来看，儿童哮喘对COVID-19严重程度及预后没有显著影响。需要进一步开展纵向研究来验证我们的结论，并探究COVID-19严重程度及预后与变应原免疫治疗以及哮喘治疗中生物制剂使用之间的关系。
