The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil
Objective There have been conflicting reports on the relationship between asthma and COVID‐19 severity. This study aimed to compare the risk of death among children with asthma and healthy peers hospitalized due to COVID‐19. Methods We carried out an analysis of all pediatric patients 2–19 years of...
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| Published in: | Pediatric pulmonology Vol. 58; no. 3; pp. 727 - 737 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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01-03-2023
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| Abstract | Objective
There have been conflicting reports on the relationship between asthma and COVID‐19 severity. This study aimed to compare the risk of death among children with asthma and healthy peers hospitalized due to COVID‐19.
Methods
We carried out an analysis of all pediatric patients 2–19 years of age with asthma and COVID‐19 registered in Influenza Epidemiological Surveillance Information System‐Gripe, a Brazilian nationwide surveillance database, between February 2020 and March 2022. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk using the cumulative incidence function.
Results
Among 30,405 hospitalized children with COVID‐19, 21,340 (70.2%) had no comorbidities, 6444 (21.2%) had comorbidities other than asthma, 2165 (7.1%) had asthma, and 465 (1.5%) had asthma with other comorbidities. The estimated probability of a fatal outcome for each group was 4.1%, 14.9%, 2.1%, and 10.7%, respectively. After adjustment, children with asthma had a 60% reduction in the hazard of death than healthy peers (hazard ratio [HR] = 0.39, 95% confidence interval [CI], 0.29–0.53, p < 0.0001). Among children with asthma and no other comorbidities, two covariates were independently associated with in‐hospital mortality, age ≥12 years, HR = 4.0, 95% CI, 2.5–6.4), and low oxygen saturation at admission (HR = 2.3, 95% CI, 1.4–3.2).
Conclusion
Children with asthma and no comorbidities had a lower risk of death compared with healthy peers after controlling for clinical and demographic confounding factors. |
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| AbstractList | There have been conflicting reports on the relationship between asthma and COVID-19 severity. This study aimed to compare the risk of death among children with asthma and healthy peers hospitalized due to COVID-19.
We carried out an analysis of all pediatric patients 2-19 years of age with asthma and COVID-19 registered in Influenza Epidemiological Surveillance Information System-Gripe, a Brazilian nationwide surveillance database, between February 2020 and March 2022. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk using the cumulative incidence function.
Among 30,405 hospitalized children with COVID-19, 21,340 (70.2%) had no comorbidities, 6444 (21.2%) had comorbidities other than asthma, 2165 (7.1%) had asthma, and 465 (1.5%) had asthma with other comorbidities. The estimated probability of a fatal outcome for each group was 4.1%, 14.9%, 2.1%, and 10.7%, respectively. After adjustment, children with asthma had a 60% reduction in the hazard of death than healthy peers (hazard ratio [HR] = 0.39, 95% confidence interval [CI], 0.29-0.53, p < 0.0001). Among children with asthma and no other comorbidities, two covariates were independently associated with in-hospital mortality, age ≥12 years, HR = 4.0, 95% CI, 2.5-6.4), and low oxygen saturation at admission (HR = 2.3, 95% CI, 1.4-3.2).
Children with asthma and no comorbidities had a lower risk of death compared with healthy peers after controlling for clinical and demographic confounding factors. Objective There have been conflicting reports on the relationship between asthma and COVID‐19 severity. This study aimed to compare the risk of death among children with asthma and healthy peers hospitalized due to COVID‐19. Methods We carried out an analysis of all pediatric patients 2–19 years of age with asthma and COVID‐19 registered in Influenza Epidemiological Surveillance Information System‐Gripe, a Brazilian nationwide surveillance database, between February 2020 and March 2022. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk using the cumulative incidence function. Results Among 30,405 hospitalized children with COVID‐19, 21,340 (70.2%) had no comorbidities, 6444 (21.2%) had comorbidities other than asthma, 2165 (7.1%) had asthma, and 465 (1.5%) had asthma with other comorbidities. The estimated probability of a fatal outcome for each group was 4.1%, 14.9%, 2.1%, and 10.7%, respectively. After adjustment, children with asthma had a 60% reduction in the hazard of death than healthy peers (hazard ratio [HR] = 0.39, 95% confidence interval [CI], 0.29–0.53, p < 0.0001). Among children with asthma and no other comorbidities, two covariates were independently associated with in‐hospital mortality, age ≥12 years, HR = 4.0, 95% CI, 2.5–6.4), and low oxygen saturation at admission (HR = 2.3, 95% CI, 1.4–3.2). Conclusion Children with asthma and no comorbidities had a lower risk of death compared with healthy peers after controlling for clinical and demographic confounding factors. OBJECTIVEThere have been conflicting reports on the relationship between asthma and COVID-19 severity. This study aimed to compare the risk of death among children with asthma and healthy peers hospitalized due to COVID-19. METHODSWe carried out an analysis of all pediatric patients 2-19 years of age with asthma and COVID-19 registered in Influenza Epidemiological Surveillance Information System-Gripe, a Brazilian nationwide surveillance database, between February 2020 and March 2022. The primary outcome was time to death, which was evaluated considering discharge as a competitive risk using the cumulative incidence function. RESULTSAmong 30,405 hospitalized children with COVID-19, 21,340 (70.2%) had no comorbidities, 6444 (21.2%) had comorbidities other than asthma, 2165 (7.1%) had asthma, and 465 (1.5%) had asthma with other comorbidities. The estimated probability of a fatal outcome for each group was 4.1%, 14.9%, 2.1%, and 10.7%, respectively. After adjustment, children with asthma had a 60% reduction in the hazard of death than healthy peers (hazard ratio [HR] = 0.39, 95% confidence interval [CI], 0.29-0.53, p < 0.0001). Among children with asthma and no other comorbidities, two covariates were independently associated with in-hospital mortality, age ≥12 years, HR = 4.0, 95% CI, 2.5-6.4), and low oxygen saturation at admission (HR = 2.3, 95% CI, 1.4-3.2). CONCLUSIONChildren with asthma and no comorbidities had a lower risk of death compared with healthy peers after controlling for clinical and demographic confounding factors. |
| Author | Martelli‐Júnior, Hercílio Vasconcelos, Mariana A. Simões e Silva, Ana C. Mak, Robert H. Colosimo, Enrico A. Silva, Ludmila R. Oliveira, Maria C. L. Pinhati, Clara C. Oliveira, Eduardo A. |
| Author_xml | – sequence: 1 givenname: Maria C. L. surname: Oliveira fullname: Oliveira, Maria C. L. organization: Federal University of Minas Gerais (UFMG) – sequence: 2 givenname: Enrico A. surname: Colosimo fullname: Colosimo, Enrico A. organization: Federal University of Minas Gerais – sequence: 3 givenname: Mariana A. surname: Vasconcelos fullname: Vasconcelos, Mariana A. organization: Federal University of Minas Gerais (UFMG) – sequence: 4 givenname: Hercílio surname: Martelli‐Júnior fullname: Martelli‐Júnior, Hercílio organization: State University of Montes Claros (Unimontes) – sequence: 5 givenname: Robert H. surname: Mak fullname: Mak, Robert H. organization: University of California, San Diego – sequence: 6 givenname: Ludmila R. surname: Silva fullname: Silva, Ludmila R. organization: Federal University of Minas Gerais (UFMG) – sequence: 7 givenname: Clara C. surname: Pinhati fullname: Pinhati, Clara C. organization: Federal University of Minas Gerais (UFMG) – sequence: 8 givenname: Ana C. surname: Simões e Silva fullname: Simões e Silva, Ana C. organization: Federal University of Minas Gerais (UFMG) – sequence: 9 givenname: Eduardo A. orcidid: 0000-0002-5642-7164 surname: Oliveira fullname: Oliveira, Eduardo A. email: eduolive812@gmail.com organization: Federal University of Minas Gerais (UFMG) |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36382503$$D View this record in MEDLINE/PubMed |
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There have been conflicting reports on the relationship between asthma and COVID‐19 severity. This study aimed to compare the risk of death among... There have been conflicting reports on the relationship between asthma and COVID-19 severity. This study aimed to compare the risk of death among children with... ObjectiveThere have been conflicting reports on the relationship between asthma and COVID‐19 severity. This study aimed to compare the risk of death among... OBJECTIVEThere have been conflicting reports on the relationship between asthma and COVID-19 severity. This study aimed to compare the risk of death among... |
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| SubjectTerms | Adolescent Asthma Asthma - epidemiology Brazil - epidemiology Child children Comorbidity COVID-19 COVID-19 - epidemiology Hospitalization Humans outcome risk factors SARS-CoV-2 |
| Title | The association between pre‐existing asthma and reduced risk of death among children and adolescents hospitalized with COVID‐19 in Brazil |
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