UNCONTROLLED asthma in children has been linked to elevated risk of COVID-19-related hospitalisation, a study has found. Aziz Sheikh, Director of the Asthma UK Centre for Applied Research (AUKCAR), University of Edinburgh, Scotland, and colleagues, reported that children with poorly-controlled asthma, defined as having a history of asthma-linked hospitalisations in the 2 years before the pandemic, were six times more likely to suffer the worst COVID-19 outcomes compared with children without asthma. On the contrary, children suffering from asthma which was well controlled, characterised by no history of asthma-linked hospitalisations in the 2 years before the pandemic, were only slightly more at risk of serious COVID-19 outcomes compared with children without asthma. Overall, the investigation also found an increased COVID-19 hospitalisation risk in children aged 5 to 11, even when the asthma was well controlled, according to the parameters of this study.
Expanding on this comparison, Sheikh and colleagues observed that children who had been prescribed two or more courses of oral corticosteroids, a factor used as a marker for uncontrolled asthma, were at a significantly higher risk of COVID-19 hospitalisation compared to children without asthma.
Commenting on the significance of these findings, Sheikh stressed the importance of considering priority groups for vaccine distribution: “Understanding which children with asthma are at increased risk of serious COVID-19 outcomes is critical to ongoing policy deliberations on vaccine prioritisation.” Katherine Poehling, an infectious disease specialist and vaccinologist at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina, USA, went on to remark of the importance of highlighting the key role that influenza and COVID-19 vaccinations play in protecting children with underlying health conditions from preventable hospitalisations.
This investigation used data from the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) to determine the children with asthma that were most likely to suffer serious COVID-19 outcomes. While data from this investigation should be treated with caution due to limitations of the study design, Sheikh summarised the relevance of these findings: “The key takeaway from this study is that keeping children’s asthma under control is critical as this greatly reduces the risk of COVID-19 hospitalisation.”