Obesity is a risk factor for decrease in lung function after COVID-19 infection in children with asthma.

Abstract

IntroductionIt is not clear whether asthma, the most frequent chronic disease in childhood, is a risk for severe SARS‐CoV‐2 infection in the pediatric population and how SARS‐CoV‐2 infection affects the lung functions in these patients.PurposeWe aimed to investigate the course and the consequences of SARS‐CoV‐2 infection among children with asthma and determine the risk factors for the decline in lung function tests (LFTs).MethodsIn this retrospective study, asthmatic children with coronavirus disease 2019 (COVID‐19) were compared with a random control group of asthmatic patients without COVID‐19. In addition, the clinical course and the effect on LFTs of COVID‐19 among children with asthma were also evaluated.ResultsOne hundred eighty‐nine patients who had COVID‐19, and 792 who did not were included in the study. Fever, fatigue, and cough were the most frequent symptoms during COVID‐19. Regarding the severity of COVID‐19, 163 patients (87.6%) had a mild clinical condition, 13 (7%) had moderate disease, 1 (0.5%) had severe disease, and 2 had (1.1%) critically ill disease. Two patients were diagnosed with multisystem inflammatory syndrome in children (MIS‐C), one patient suffered from pneumothorax. LFTs of the patients before and after COVID‐19 infection were analyzed; no significant differences were found in FEV1% (91.7% vs. 90.9%, p = 0.513), FVC% (89.8% vs. 90.8%, p = 0.502) and FEV1/FVC (103.1% vs. 100.6%, p = 0.056), while FEF25%–75% values (107.6% vs. 98.4%, p < 0.001) were significantly lower after the COVID‐19 infection. Obesity (odds ratio [OR]: 3.785, 95% confidence interval [CI]: 1.152–12.429, p = 0.028] and having a family history of atopy (OR: 3.359, 95% CI: 1.168–9.657, p = 0.025] were found to be the independent risk factors for ≥25% decrease in FEF25–75 after COVID‐19 infection.ConclusionCOVID‐19 infection leads to dysfunction of the small airways in asthmatic children and obesity is an independent risk factor for a ≥25% decrease in FEF25–75. The long‐term effects of COVID‐19 infection especially on small airways require close monitoring in children with asthma.