Özata Muhammet Cihat, Dikici Ümmügülsüm, Özdemir Öner
Medical Faculty, Sakarya University, Adapazarı 54100, Sakarya, Türkiye.
Department of Pediatric Allergy and Immunology, Sakarya University, Adapazarı 54100, Sakarya, Türkiye.
World J Virol. 2023 Dec 25;12(5):272-285. doi: 10.5501/wjv.v12.i5.272.
The epidemic of severe acute respiratory syndrome coronavirus 2 infection, known as the coronavirus disease 2019 (COVID-19), has caused a global health concern. Since its emergence, numerous studies have focused on various clinical manifestations and outcomes in different populations. However, studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are controversial.
To fill this research gap by retrospectively evaluating the course, laboratory, and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had COVID-19.
The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing system. The data included retrospective evaluation of pulmonary function test results before and after COVID-19, routine hematological and biochemical parameters, sensitization states (total IgE, specific IgE, and skin prick test results), and radiological (computed tomography) findings. To inquire about the course and symptoms of COVID-19, asthma patients or their parents were then called and evaluated with a questionnaire.
As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5, it was determined that 414 (7.5%) patients had COVID-19. The mean age of 414 patients was 17.18 ± 4.08 (min: 6; max: 28) years. Two hundred and three of our 414 patients are male, and 211 are female. When their vaccination status was questioned, 21.5% were vaccinated. When the symptoms of our 290 patients were questioned, it was stated that 59.0% had fever symptoms. The rate of using regular prophylactic asthma medications was 19%. The rate of using salbutamol in asthma was found to be 22%. The rate of patients using methylprednisolone was 1%. Emergency service admission was 17.2%, and hospitalization was found to be 4.8%. Leukopenia (< 4000) was found in 14.1% of patients, and 8.08% of our patients had neutropenia (< 1500). Lymphopenia (< 1500) was detected in 44.4% of patients, and lymphocytosis (> 4000) was found in 5.05% of patients. In 65% of our patients, the C-reactive protein value was elevated. A high aspartate aminotransferase and alanine aminotransferase value was detected in 3.2% and 5.4% of patients were found, respectively. 31% of patients had an elevated lactate dehydrogenase value. Typical radiological findings for COVID-19 were detected in 3/309 of patients.
According to our study, there is a correlation between the severity of COVID-19 and asthma symptoms and the course of the disease. However, it is worth noting that the retrospective nature of the study and the differences in sample size, age, and demographic characteristics between the two groups do not allow for an optimal comparison. Therefore, further investigation is needed to explore the relationship between COVID-19 and asthma, and it can be suggested that COVID-19 may trigger asthma attacks and asthma may impact the course of COVID-19.
严重急性呼吸综合征冠状病毒2感染的流行，即2019冠状病毒病（COVID-19），已引起全球对健康的关注。自其出现以来，众多研究聚焦于不同人群的各种临床表现和结局。然而，由于COVID-19对哮喘等慢性病患儿的后果和影响存在争议，相关研究仍在进行中。
通过回顾性评估414名来自儿科过敏门诊且已知感染COVID-19的哮喘患儿的病程、实验室检查及临床结果，填补这一研究空白。
使用医院档案系统中的病历号，以特定参数对我院数据库中5510例5岁以上诊断为哮喘的患者数据进行回顾性筛查。数据包括对COVID-19前后肺功能测试结果、常规血液学和生化参数、致敏状态（总IgE、特异性IgE和皮肤点刺试验结果）以及放射学（计算机断层扫描）结果的回顾性评估。为了解COVID-19的病程和症状，随后致电哮喘患者或其父母并通过问卷进行评估。
通过对5510例5岁以上哮喘患者的数据进行回顾性筛查，确定414例（7.5%）患者感染了COVID-19。414例患者的平均年龄为17.18±4.08岁（最小6岁；最大28岁）。414例患者中，203例为男性，211例为女性。询问其疫苗接种情况时，21.5%的患者已接种疫苗。询问290例患者的症状时，称59.0%的患者有发热症状。使用常规预防性哮喘药物的比例为19%。哮喘患者中使用沙丁胺醇的比例为22%。使用甲泼尼龙的患者比例为1%。急诊入院率为17.2%，住院率为4.8%。14.1%的患者出现白细胞减少（<4000），8.08%的患者出现中性粒细胞减少（<1500）。44.4%的患者检测到淋巴细胞减少（<1500），5.05%的患者出现淋巴细胞增多（>4000）。65%的患者C反应蛋白值升高。分别有3.2%和5.4%的患者检测到天冬氨酸转氨酶和丙氨酸转氨酶值升高。31%的患者乳酸脱氢酶值升高。309例患者中有3例检测到COVID-19的典型放射学表现。
根据我们的研究，COVID-19的严重程度与哮喘症状及疾病病程之间存在相关性。然而，值得注意的是，该研究的回顾性性质以及两组之间样本量、年龄和人口统计学特征的差异不允许进行最佳比较。因此，需要进一步研究以探索COVID-19与哮喘之间的关系，可以认为COVID-19可能引发哮喘发作，而哮喘可能影响COVID-19的病程。
