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Disclosures: Shi reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
December 01, 2021
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COVID-19 hospitalization risk elevated in children with poorly controlled asthma

Disclosures: Shi reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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In a new study, school-aged children in Scotland with uncontrolled asthma had a 3 to 6 times higher risk for COVID-19 hospitalization compared with those without asthma, researchers reported in The Lancet Respiratory Medicine.

“The findings from this linkage of multiple data sources have helped inform the prioritization of school-aged children with poorly controlled asthma for vaccines,” Ting Shi, PhD, chancellor’s fellow at the Usher Institute, University of Edinburgh, U.K., and colleagues wrote.

Source: Adobe Stock.

The study included all children in Scotland aged 5 to 17 years in the Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) linked dataset from March 2020 to July 2021. The researchers evaluated the risk for COVID-19 hospitalization among children with markers of uncontrolled asthma, which was defined as a previous asthma hospitalization or prescriptions for oral corticosteroids within the previous 2 years.

Among 752,867 children, 8.4% had clinician-diagnosed and recorded asthma; of those, 6.8% had confirmed SARS-CoV-2 infection.

Of those with a confirmed infection, 1.5% were hospitalized with COVID-19.

When the researchers evaluated children without asthma (n = 689,404), 5.8% had confirmed SARS-CoV-2 infection and, of those, 0.9% were hospitalized with COVID-19.

The researchers reported a higher rate of COVID-19 hospitalization among children with poorly controlled asthma than those with well controlled or no asthma. Compared with patients without asthma, the adjusted HR for COVID-19 hospitalization in those with a previous admission for asthma was 6.4 (95% CI, 3.27-12.53) for those with poorly controlled asthma and 1.36 (95% CI, 1.02-1.8) for those with well-controlled asthma, according to the results. Compared with patients without asthma, the adjusted HR for COVID-19 hospitalization in those with a history of oral corticosteroids, the adjusted HR was 3.38 (95% CI, 1.84-6.21) for those with three or more prescribed courses, 1.52 (95% CI, 0.9-2.57) for those with one course and 1.34 (95% CI, 0.98-1.82) for those not prescribed oral corticosteroids, according to the results.

“Although the HR was elevated, the overall risk of admission to hospital with SARS-CoV-2 in children with asthma was low (1 in 380 children with poorly controlled asthma were admitted to hospital with COVID-19,” the researchers wrote.

“... This analysis also underscores the importance of maintaining good asthma control and careful monitoring of children with poorly controlled asthma if they develop SARS-CoV-2 infection. Good asthma control could help to protect children from developing more severe manifestations of COVID-19,” Shi and colleagues wrote.