Do children with or without asthma have a similar risk of SARS-CoV2 infection?

Risk factors for SARS-CoV-2 infection among children are still poorly defined. Individuals with asthma are currently advised to take additional precautions to prevent SARS-CoV-2 infection (the virus that causes COVID-19), but the relationship between asthma and SARS-CoV-2 infection risk and severity in children is unclear. A retrospective cohort study was conducted of children (5 to 17 years of age) receiving care in the Duke University Health System, a large integrated health system in central North Carolina. Children were classified as having asthma based on their electronic health record, while SARS-CoV-2 infections were identified based on positive polymerase chain reaction testing. Read: Risk of neurodevelopmental disorders after prenatal exposure to antiseizure meds This study was conducted during a 19-month period (March 1, 2020 to September 30, 2021). Children with asthma were matched 1:1 to children without asthma, and the association between asthma and SARS-CoV-2 infection risk was evaluated. As secondary objectives, the authors also evaluated whether the use of inhaled corticosteroids, a history of severe asthma exacerbations or the presence of comorbid atopic diseases modified the association between asthma and SARS-CoV-2 infection risk. Results showed the following: Of 46,900 children, 6,324 (13.5%) had asthma. Overall, 10,566 (22.5%) children had one or more tests for SARS-CoV-2 during the 19-month study period. Children with asthma were more likely to be tested for SARS-CoV-2 infection than children without asthma (33.0% vs 20.9%, p < 0.0001). In a propensity score-matched cohort of 12,648 children, 706 (5.6%) children tested positive for SARS-CoV-2 infection, including 350 (2.8%) children with asthma and 356 (2.8%) children without asthma (risk ratio: 0.98, 95% confidence interval [CI]: 0.85–1.13). Similar risks of SARS-CoV-2 infection were seen among children with asthma who were prescribed an inhaled corticosteroid (RR: 0.88, 95% CI: 0.73–0.94) and those who were not (RR: 1.08, 95% CI: 0.89–1.34). No difference was noted in the risk of SARS-CoV-2 infection among children with a history of severe asthma exacerbation (RR: 0.95, 95% CI: 0.71–1.25) and children who did not have a history of severe exacerbation (RR: 1.00, 95% CI: 0.84–1.18). The risk of SARS-CoV-2 infection was similar among children who had a diagnosis of comorbid atopic disease (RR: 0.94, 95% CI: 0.79–1.12) and those who did not have this comorbidity (RR: 1.07, 95% CI: 0.83–1.38). The study did not identify an association between asthma and COVID-19 severity. Only one child with asthma required hospitalization for SARS-CoV-2 infection. In this study, children with asthma had a similar SARS-CoV-2 infection risk as children without asthma. Inhaled corticosteroid use, history of severe exacerbation or comorbid atopic diseases did not affect the risk of SARS-CoV-2 infection. Hospitalization among children with COVID-19 was infrequent, including among children with asthma. Overall, the investigators found no evidence that asthma predisposes children to SARS-CoV-2 infection or severe illness from COVID-19. The authors caution that further research is needed to evaluate the complex relationships between medical comorbidities, such as asthma, and SARS-CoV-2 infection among children. Reference 1. Rao S, Hurst JH, Zhao C, et al. Asthma and the risk of SARS-CoV-2 infection among children and adolescents. Pediatrics 2022;149(6):e2021056164. (accessed June 2, 2022).

Do children with or without asthma have a similar risk of SARS-CoV2 infection?

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