Asthma and the risk for COVID-19 in children and adolescents

Introduction – logic says, that children and adolescents with asthma will have higher incidence of COVID-19 infection and will have a severe illness. We know that every simple respiratory virus may trigger an asthma attack (RSV as an example, read more here). So why should COVID-19 infection be any different?

Methods – a prospective research on children aged 5-18 years in North Carolina, USA. In a very simple, retrospective manner, children from the study group (children who were diagnosed with asthma in the past), and children from the control group (children without asthma), on a ratio of 1:1, were inspected regarding the risk for COVID-19 infection and severe illness.

Results – the researchers started with a cohort of almost 47,000 children, 6324 of them (13.5%) had been diagnosed with asthma in the past. When comparing the study and the control group, it was found that children with asthma tended to get examined more for COVID-19 than children without asthma. The infection rates were similar in both groups, even after adjusting them to the asthma severity and treatments these children were receiving. The hospitalization rates were low in both groups.

Conclusion – why do I like this study? Since its conclusion is the exact impression most of pediatricians has; that children tend to have a very mild illness. Except for very specific rare severe cases and for PIMS (pediatric inflammation multisystem syndrome), COVID-19 was not a severe disease in pediatric population. Moreover, we know from other respiratory viruses, that any simple virus can trigger an asthma attack, so even that simple thing – COVID-19 virus fails to do.

So I wish we would have known that 2 years ago. And spared parents a lot of headache and sleepless nights. But, we still need to say it out loud – children are not, and I hope will never be, in risk factor for severe infection with COVID-19. Not even those with asthma.