一组哮喘儿童的COVID-19:表现、严重程度和结果

IF 1.4 Q4 IMMUNOLOGY American journal of clinical and experimental immunology Pub Date : 2022-01-01
Zeineb A El-Sayed, Rasha H El-Owaidy, Waleed N Harb, Ghada A Shousha
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摘要

背景:关于哮喘儿童COVID-19严重程度的数据不足。目的:评价哮喘对COVID-19严重程度和转归的影响。患者和方法:我们开展了一项观察性研究,包括两组匹配的确诊/可能患有COVID-19的儿童:30名患有哮喘和32名未患有哮喘的6-18岁儿童,他们连续从埃及艾因沙姆斯大学儿童医院入组。比较两组患者新冠肺炎的临床表现、实验室和影像学异常、严重程度和预后。根据GINA 2020评估哮喘严重程度和控制情况。结果:新冠肺炎哮喘患儿中,男童9例,女童21例,中位年龄9岁,IQR 8 ~ 12岁。非哮喘性COVID-19组男性18例,女性14例,中位年龄9.5岁,IQR 7 ~ 12.5岁。两组患者COVID-19的临床表现具有可比性,但哮喘患者更常出现喘息症状(p=0.001)。1例哮喘患者和3例非哮喘患者诊断为多系统炎症综合征(MIS-c)。哮喘组血清铁蛋白、LDH和d -二聚体的升高频率高于非哮喘组(p值分别为0.014、0.001和0.015)。根据CO-RAD分级,70%的哮喘患者的CO-RAD评分为5分,而非哮喘组的CO-RAD评分为6.3%,两组患者的CO-RAD评分差异有统计学意义(P=0.002)。各组间COVID-19严重程度具有可比性(P=0.775), COVID-19结局和住院时间具有可比性(P值分别为0.999和0.655)。结论:从我们有限的样本量研究中,儿童哮喘对COVID-19的严重程度和结局没有显著影响。需要进一步的纵向研究来验证我们的结论,并调查COVID-19严重程度和结果与过敏原免疫治疗和使用生物制剂治疗哮喘的关系。
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COVID-19 in a group of children with asthma: presentation, severity, and outcome.

Background: There are insufficient data concerning COVID-19 severity among asthmatic children.

Aim: to evaluate the impact of asthma on COVID-19 severity and outcome.

Patients and methods: We carried out an observational study that comprised 2 matched groups of children with confirmed/probable COVID-19: 30 with and 32 without asthma aged 6-18 years, who were enrolled consecutively from Children's Hospital, Ain Shams University, Egypt. COVID-19 clinical presentations, laboratory and radiological abnormalities, severity and outcome were compared between the 2 groups. Asthma severity and control were assessed based on GINA 2020.

Results: The asthmatic COVID-19 children were 9 boys and 21 girls, with median age 9 years, IQR: 8-12 years. The non-asthmatic COVID-19 group included 18 males and 14 females with median age 9.5 years, IQR: 7-12.5 years. Clinical manifestations of COVID-19 were comparable among the 2 groups, except for wheezes which were more frequently encountered as a COVID-19 manifestation among the asthmatics (p=0.001). Multisystem inflammatory syndrome (MIS-c) was diagnosed in one asthmatic and 3 non-asthmatic patients. The asthmatic group had higher frequency of serum ferritin, LDH and D-dimer elevations compared to the non-asthmatic peers (p values 0.014, 0.001, and 0.015 respectively). Based on CO-RAD classification, 70% of the asthmatic patients had CO-RAD score of 5 versus 6.3 % among the non-asthmatic group with significant differences between the 2 groups in their CO-RAD scores (P=0.002). COVID-19 severity was comparable among the studied groups (P=0.775), as well as COVID-19 outcome and duration of hospital stay (p values 0.999, and 0.655, respectively).

Conclusion: From our limited sample sized study, childhood asthma did not pose a significant impact on COVID-19 severity and outcome. Further longitudinal studies are warranted to validate our conclusion and investigate the relation of COVID-19 severity and outcome to allergen immunotherapy and the use of biologicals for asthma treatment.

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