ABSTRACT
Background: The role of pediatric asthma in susceptibility to COVID-19 is poorly defined. The aim of our study was to assess possible risk factors for severe COVID-19 in children with asthma. Method(s): In our observational study, we systematically assessed the occurrence of COVID-19 in children with asthma <18 years in a six-month period prior to their regular outpatient visit in our asthma clinic from December 1, 2020 to March 31, 2021, by using a predefined questionnaire. We compared characteristics of patients presenting with signs of SARS-CoV-2 upper (URTI) or lower respiratory tract infection (LRTI), focusing on factors that could be associated with severity of COVID-19, such as asthma phenotype, treatment with inhaled corticosteroids (ICS), asthma severity and the degree of asthma control assessed by the Asthma Control Test at the outpatient visit. Result(s): Out of 210 screened patients, 27% (57/210) reported exposure to COVID-19. Forty-two children were symptomatic after the exposure. In the symptomatic group, 64% (27/42) reported symptoms of URTI and 36% (15/42) of LRTI. We observed poorer asthma control in patients with LRTI compared to URTI (80% vs 7%, p <0.001). Moreover, patients with LRTI were older (14.6+/-3.2 years vs 12.0+/-4.1 years, p=.042), more frequently girls (60% vs 26%, p=.029), with a non-allergic asthma phenotype (43% vs 13%, p=.020). Regular ICS use and asthma severity were not associated with COVID-19 presentation in these children. However, patients on regular ICS had better asthma control (p=.026). Conclusion(s): The results of our study suggest that good asthma control, treatment adherence optimization and allergic asthma phenotype enable better COVID-19 outcomes in children with asthma.