Background: Most asthma exacerbations are caused by viral respiratory infections such as rhinovirus, coronaviruses, influenza viruses, and many others. While there have been data about the impact of COVID-19 on adult asthma, much remains unknown about the impact of COVID-19 on childhood asthma.
Methods: This retrospective cohort study included all pediatric patients aged 2 to 12 years who were admitted to Abha Maternity and Children Hospital for acute asthma exacerbation between June 1, 2020, and May 31, 2021, and underwent testing for SARS-CoV-2 using nasopharyngeal real-time polymerase chain reaction.
Results: Sixty children hospitalized with the diagnosis of asthma were included in the study. Out of these patients, 10 (16.7%) were diagnosed with COVID-19. The enrolled patients were between 2 and 12 years, with a median age of five years (interquartile range, 3.8), and 58% were males (35/60). Cough, shortness of breath, and hypoxia were the most common presenting symptoms and signs. Severe asthma was more prevalent among positive COVID-19 compared with negative COVID-19 patients (60 vs 20%; P= 0.016). In addition, chronic asthma for more than five years was more prevalent among positive COVID-19 than negative COVID-19 patients (60 vs 40%, P= 0.305). Fifty-five percent of the enrolled patients had eosinophilic asthma using a 300cells/μL threshold. None of the children required invasive respiratory support (ventilation through an endotracheal tube or tracheostomy), but 12 patients (21.7%) required respiratory support via high-flow nasal cannula. The total days of hospitalization in either PICU or pediatric general ward did not differ between the two groups. All patients were discharged, and there were no reports of serious morbidity or mortality.
Conclusion: Eosinophilic asthma was the most prevalent asthma phenotype in the study group. Furthermore, there was no difference in the presenting symptoms of an asthma flare-up, laboratory indicators, and hospitalization outcomes (critical care admission and hospital stay) between asthmatics with and without a COVID-19 diagnosis.



中文翻译：

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疑似和确诊 2019 年冠状病毒病 (COVID-19) 患儿的小儿哮喘加重：沙特阿拉伯的一项观察性研究

背景：大多数哮喘发作是由病毒性呼吸道感染引起的，例如鼻病毒、冠状病毒、流感病毒等。尽管已有关于 COVID-19 对成人哮喘影响的数据，但关于 COVID-19 对儿童哮喘的影响仍有许多未知之处。
方_鼻咽实时聚合酶链反应。
结果：该研究包括 60 名因哮喘诊断而住院的儿童。在这些患者中，有 10 人（16.7%）被诊断出患有 COVID-19。入组患者年龄在 2 至 12 岁之间，中位年龄为 5 岁（四分位距，3.8），58% 为男性（35/60）。咳嗽、呼吸急促和缺氧是最常见的症状和体征。与 COVID-19 阴性患者相比，COVID-19 阳性患者的重症哮喘更为普遍（60% 对 20%；P=0.016）。此外，与 COVID-19 阴性患者相比，COVID-19 阳性患者中超过 5 年的慢性哮喘更普遍（60% vs 40%，P=0.305）。使用 300 细胞/μL 阈值，55% 的入组患者患有嗜酸性哮喘。没有一名儿童需要有创呼吸支持（通过气管插管或气管切开术进行通气），但 12 名患者（21.7%）需要通过高流量鼻导管进行呼吸支持。在 PICU 或儿科普通病房的总住院天数在两组之间没有差异。所有患者均已出院，没有严重发病或死亡的报告。
结论：嗜酸性粒细胞哮喘是研究组中最普遍的哮喘表型。此外，哮喘发作的症状、实验室指标和住院结局（重症监护入院和住院时间）在确诊和未确诊 COVID-19 的哮喘患者之间没有差异。