key: cord-0709918-gdw21ouf
authors: Al Yazidi, Laila S; Al Maskari, Nawal; Al Reesi, Mohammed
title: CHILDREN WITH ASTHMA HOSPITALISED WITH COVID‐19: MULTICENTRE EXPERIENCE
date: 2021-02-27
journal: J Paediatr Child Health
DOI: 10.1111/jpc.15415
sha: b3f3961469fd26c2a91d5fda6b5d72e1a1d7f3bd
doc_id: 709918
cord_uid: gdw21ouf

nan

Additional Supporting Information may be found in the online version of this article at the publisher's web-site: The Centers for Disease Control and Prevention states that ' People with moderate to severe asthma may be at higher risk of getting very sick from COVID-19', but does not reference this statement. 1 A Korean study of 7272 adult COVID-19 patients, of whom 686 also had asthma, found that asthma was not a significant risk factor for respiratory failure (odds ratio = 0.99, P = 0.997) or mortality (odds ratio = 1.06, P = 0.759). 2 There are very few publications in children and it is unclear whether or not children with asthma are at increased risk from COVID-19 infection, [3] [4] [5] nor is it clear whether COVID-19 is a potent trigger of exacerbations of asthma.

We report our experience of 223 children hospitalised with COVID-19 in three main paediatric admitting centres in Oman: Sultan Qaboos University Hospital, Royal Hospital and Sohar Hospital. Five (2%) had acute exacerbation of asthma, requiring salbutamol and corticosteroids. Their median age was 4 years. Three required oxygen therapy and two were observed in high dependency, but none required assisted ventilation. The length of hospital stay was 3 days on average, and all had full recovery (Table 1) .

Seasonal coronaviruses tend to cause fewer asthma exacerbations compared to other viruses such as influenza. 5 Retrospective studies from Slovenia and the USA showed a significant reduction in emergency visits and hospitalisations among children with asthma compared to the pre-COVID era. 5 Possible explanations include less exposure to outdoor aeroallergens, reduced pollution with the lockdown during the pandemic, better asthma control, fewer viral triggers due to school and pre-school closures, and maybe a higher threshold for emergency presentations. 3, 5 In addition, children with asthma may be protected against COVID-19 due to reduced expression of the angiotensin-converting enzyme 2 receptor required for coronavirus recognition and infection. 5 School attendance is not discouraged in children with asthma if a safe school return can be ensured by focusing on asthma control, maintaining good hand hygiene, proper social distancing, access to influenza vaccination, improving ventilation in class rooms, wearing masks when appropriate and avoiding irritant cleaning products at school. 5 Asthma was not found to be a risk factor for severe COVID-19 among children in Oman. It is still unclear whether this is related to school and pre-school closures until recently. With the gradual opening of schools, we should be vigilant to watch for the severity of COVID-19 in this population. Optimising asthma management is the key to preventing severe disease in these children. [3] [4] [5] 

Letters to the Editor

COVID-19. People with Moderate to Severe Asthma. United States: CDC; 2021

Impact of comorbid asthma on severity of coronavirus disease (COVID-19)

COVID 19 and pediatric asthma

Asthma and COVID-19 in children: A systematic review and call for data

Pediatric asthma and COVID-19: The known, the unknown, and the controversial