Children with asthma ‘bounce back’ with symptom control, lung function after COVID-19
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Key takeaways:
- Compared with baseline, 30 of 171 patients with asthma had significantly worse ACT or CACT scores after COVID-19.
- Also, 33 of 114 patients with asthma had significantly worse FEV1 totals after infection.
WASHINGTON — Children with asthma did not see any significant differences in lung function or symptom control up to 18 months after acute COVID-19, according to data presented at the American Thoracic Society International Conference.
These results indicate that COVID-19 does not impact long-term severity or control among children with asthma, Kristina M. Gaietto, MD, MPH, clinical instructor of pediatrics and postdoctoral scholar, division of pediatrics, University of Pittsburgh School of Medicine and UPMC Children’s Hospital of Pittsburgh, and colleagues wrote.
“Obviously, COVID is a pretty new, recent phenomenon, so we’re still learning long-term outcomes,” Gaietto told Healio.
“And there really haven’t been a lot of studies that have looked at the long-term impact of COVID on children with asthma. So, we wanted to see if acute COVID-19 impacts either lung function or asthma symptoms in kids with asthma,” she said.
The prospective case-control study included children and young adults with asthma aged 6 to 21 years. Patients with Asthma Control Test (ACT) or Childhood ACT (CACT) scores included 171 with COVID-19 and 113 healthy controls. Patients with spirometry results included 114 with COVID-19 and 237 healthy controls.
The researchers measured ACT or CACT scores or took spirometry at baseline and then again 18 months later in the control group or again 18 months after infection in the COVID-19 group. Markers included FEV1, forced vital capacity (FVC), FEV1/FVC, and forced expiratory volume in the middle half of the FVC curve.
“What we found was that there was no significant difference in any of the lung function measures on spirometry or in asthma symptom control after COVID,” Gaietto said. “So, very reassuring.”
Specifically, 30 of the patients with COVID-19 had significantly worse ACT or CACT scores 18 months after COVID-19, defined as a decrease of 3 points or greater, compared with 141 whose scores were not significantly worse.
Similarly, 33 of those with COVID-19 had significantly worse FEV1 results 18 months after COVID-19, and 81 did not.
“Of course, there’s some that did have worsening, and some that did have improvement,” Gaietto said. “On average? No change.”
The patients in the COVID-19 group who reported worse asthma symptom control had shorter time to follow-up at 3.5 months (range, 1.5-7.5 months) vs. the group that did not (6.1 months; range, 3.1-9.8; P = .007).
“We wonder if that’s going to resolve as we continue to follow them long-term,” Gaietto said.
Also, 46.2% of the children who reported worse asthma control after COVID-19 reported an exacerbation during their infection compared with 25.8% of those who did not have worse asthma control after COVID-19 (P = .04).
“So that may be something there,” Gaietto said.
Further, the researchers called the proportions of cases and controls with poorer asthma symptom control (17.5% vs. 9.7%) or worse lung function (29% vs. 32.5%) similar.
Gaietto said that these results would be helpful for families, who often are worried about what will happen if their child with asthma also develops or has already had COVID-19.
“We can tell them that our study has shown that there are no significant differences in asthma symptom control or lung function after COVID infection,” she said. “There are outliers, but as a whole, they bounce back.”
Gaietto also noted that the study was unique because it included controls who did not have COVID-19, adding that she and her colleagues will continue their work.
“We’re going to do a follow-up study looking at these kids 2 or 3 years after their COVID infection and see if we see if there’s any decline or if they’re just holding steady,” Gaietto said.
For more information:
Kristina M. Gaietto, MD, MPH, can be reached at kristina.gaietto@chp.edu.