1. Allergy and Clinical Immunology Department, Hospital de Dona Estefânia, CHULC, Lisbon, Portugal
2. Paediatric Infectious Diseases Department, Hospital de Dona Estefânia, CHULC, Lisbon, Portugal
3. Immunology Department, Hospital de São José, CHULC, Lisbon, Portugal
4. CEDOC, Integrated Pathophysiological Mechanisms Research Group, Nova Medical School, Lisbon, Portugal
- EAACI Congress 2021, reunião internacional, apresentação sob a forma de poster
Resumo:
Background: SARS-CoV-2 infection seems to be less severe in children. Recent data report that asthmatic children are not more affected neither have worse outcomes. Our goal was to compare clinical characteristics and outcomes of COVID-19 infection in pediatric asthmatic/ recurrent wheezers (A/RW) versus non-asthmatic/ non-recurrent wheezers (N-A/N-RW).
Method: Observational, retrospective study conducted in Hospital Dona Estefânia -Lisbon, from March 2nd to December 31st, 2020. All pediatric patients (<18 years) with positive SARS-CoV-2 (RT-PCR test) were included. Demographic data and symptoms were collected and sorted into two groups, according to A/RW diagnosis based on a previous physician’s diagnosis or a parent-reported history. In hospitalized patients, comorbidities, length of stay, hospital readmission, laboratory results, chest X-ray/ CT findings, admission in an intensive care unit (ICU), intubation and administered medication were evaluated.
Results: 537 patients were included [54% male; median age: 5 years old (P25-75:1-11)], 37 (6.7%) with A/RW. A/RW were older (p=0.015), had more cough (p<0.01), dyspnea (p<0.01) and sore throat (p=0.017) compared to the N-A/N-RW group. Only 109 were admitted because of COVID-19 infection, 9 of A/RW group (24.3%) and 100 of N-A/N-RW (20%); (p=0.527). Among COVID-19 hospitalized patients, the median length of stay was 5 (A/RW) and 3 days (N-A/N-RW) (p=0.292). Only 5 patients needed ICU admission (all N-A/N-RW). A/RW had more COVID-19 pneumonia (p=0.028) and N-A/N-RW more Multisystem Inflammatory Syndrome (p=1.000). Laboratory results showed that A/RW had higher neutrophile (p=0.002) and lymphocyte count (p=0.004). There was no statistically significant difference in chest X-ray/ CT disturbances between the groups. A/RW patients needed oxygen and systemic corticosteroids more frequently (both p<0.05). Only N-A/N-RW needed aminergic support (n=4) and ventilation (n=2); p=1.000.
Conclusion: The number of COVID-19 patients with A/RW did not seem to be too high and the percentage of hospitalizations was similar in both groups. Hospitalized A/RW had more respiratory symptoms, neutrophilia, lymphocytosis, need for oxygen or systemic corticosteroid and COVID-19 pneumonia. Nevertheless, the two groups had similar hospital stay length and no significant statistical differences regarding ICU care or ventilation needs. So, it seems that the clinical outcomes are not worse in A/RW patients, which is in agreement with previously reported data.
Palavras Chave: asthma, COVID-19, recurrent wheezing