Research Question: Is the Coronavirus (SARS CoV-2 virus) an asthma trigger resulting in poor asthma control for children?
Research Findings: This is the first large-scale nationwide study demonstrating a worsening of asthma outcomes in children during the 6 months after a PCR-confirmed COVID-19 infection. Children who tested negative for COVID-19 showed significant reductions in asthma-related hospitalizations, emergency department visits, oral corticosteroids (OCS) medication fill rates, and inhaler/nebulizer (Short-acting β-agonist (SABA)) use in the 6 months after their negative PCR test compared with 6 months before being tested for COVID-19. Asthmatic children who tested positive for COVID-19 showed significant increases in emergency department visits and OCS fills in the post-PCR period, and only slight increases in hospitalizations or SABA use after infection. During the 6 months after SARS-CoV-2 testing, COVID-19 positive patients had significantly higher morbidities in all measures compared with those who were COVID-19 negative, ED rate, hospitalization rate, OCS fill rate, and SABA fill rate.
Research Meaning: This study demonstrates that although asthma outcomes were again improved for those who tested negative for SARS-CoV-2 PCR, asthmatic children who were given a definitive diagnosis of COVID-19 have worse asthma control in the first 6 months after infection. The overall improvement in asthma control during the pandemic is hypothesized to result from hygiene and public health measures, and/or decreased exposures to particulate matter and viral triggers. In this study, the effect of COVID-19 on asthma became discernable when children who were PCR-positive were compared with those who were PCR-negative in the post-6-month period, because all metrics showed highly significant differences with this comparison. Thus, the asthma-triggering effect of SARS-CoV-2 was likely masked by the overall decrease in asthma exacerbations during the stay-at-home measures when other asthma triggers were less present in the community.
