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

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          Abstract

          Introduction

          It 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.

          Purpose

          We 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).

          Methods

          In 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.

          Results

          One 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 FEV 1% (91.7% vs. 90.9%, p = 0.513), FVC% (89.8% vs. 90.8%, p = 0.502) and FEV 1/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.

          Conclusion

          COVID‐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.

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          Epidemiological Characteristics of 2143 Pediatric Patients With 2019 Coronavirus Disease in China

          Yuanyuan Dong, Xi Mo, Yabin Hu … (2020)
          To identify the epidemiological characteristics and transmission patterns of pediatric patients with the 2019 novel coronavirus disease (COVID-19) in China.
          Article 0 comments Cited 1603 times – based on 0 reviews     Review now
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            SARS-CoV-2 Infection in Children

            Xiaoxia Lu, Liqiong Zhang, Hui Du … (2020)
            To the Editor: As of March 10, 2020, the 2019 novel coronavirus (SARS-CoV-2) has been responsible for more than 110,000 infections and 4000 deaths worldwide, but data regarding the epidemiologic characteristics and clinical features of infected children are limited. 1-3 A recent review of 72,314 cases by the Chinese Center for Disease Control and Prevention showed that less than 1% of the cases were in children younger than 10 years of age. 2 In order to determine the spectrum of disease in children, we evaluated children infected with SARS-CoV-2 and treated at the Wuhan Children’s Hospital, the only center assigned by the central government for treating infected children under 16 years of age in Wuhan. Both symptomatic and asymptomatic children with known contact with persons having confirmed or suspected SARS-CoV-2 infection were evaluated. Nasopharyngeal or throat swabs were obtained for detection of SARS-CoV-2 RNA by established methods. 4 The clinical outcomes were monitored up to March 8, 2020. Of the 1391 children assessed and tested from January 28 through February 26, 2020, a total of 171 (12.3%) were confirmed to have SARS-CoV-2 infection. Demographic data and clinical features are summarized in Table 1. (Details of the laboratory and radiologic findings are provided in the Supplementary Appendix, available with the full text of this letter at NEJM.org.) The median age of the infected children was 6.7 years. Fever was present in 41.5% of the children at any time during the illness. Other common signs and symptoms included cough and pharyngeal erythema. A total of 27 patients (15.8%) did not have any symptoms of infection or radiologic features of pneumonia. A total of 12 patients had radiologic features of pneumonia but did not have any symptoms of infection. During the course of hospitalization, 3 patients required intensive care support and invasive mechanical ventilation; all had coexisting conditions (hydronephrosis, leukemia [for which the patient was receiving maintenance chemotherapy], and intussusception). Lymphopenia (lymphocyte count, <1.2×109 per liter) was present in 6 patients (3.5%). The most common radiologic finding was bilateral ground-glass opacity (32.7%). As of March 8, 2020, there was one death. A 10-month-old child with intussusception had multiorgan failure and died 4 weeks after admission. A total of 21 patients were in stable condition in the general wards, and 149 have been discharged from the hospital. This report describes a spectrum of illness from SARS-CoV-2 infection in children. In contrast with infected adults, most infected children appear to have a milder clinical course. Asymptomatic infections were not uncommon. 2 Determination of the transmission potential of these asymptomatic patients is important for guiding the development of measures to control the ongoing pandemic.
            Article 0 comments Cited 1178 times – based on 0 reviews     Review now
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              Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

              Brian Graham, Irene Steenbruggen, Martin R Miller … (2019)
              Background: Spirometry is the most common pulmonary function test. It is widely used in the assessment of lung function to provide objective information used in the diagnosis of lung diseases and monitoring lung health. In 2005, the American Thoracic Society and the European Respiratory Society jointly adopted technical standards for conducting spirometry. Improvements in instrumentation and computational capabilities, together with new research studies and enhanced quality assurance approaches, have led to the need to update the 2005 technical standards for spirometry to take full advantage of current technical capabilities. Methods: This spirometry technical standards document was developed by an international joint task force, appointed by the American Thoracic Society and the European Respiratory Society, with expertise in conducting and analyzing pulmonary function tests, laboratory quality assurance, and developing international standards. A comprehensive review of published evidence was performed. A patient survey was developed to capture patients’ experiences. Results: Revisions to the 2005 technical standards for spirometry were made, including the addition of factors that were not previously considered. Evidence to support the revisions was cited when applicable. The experience and expertise of task force members were used to develop recommended best practices. Conclusions: Standards and consensus recommendations are presented for manufacturers, clinicians, operators, and researchers with the aims of increasing the accuracy, precision, and quality of spirometric measurements and improving the patient experience. A comprehensive guide to aid in the implementation of these standards was developed as an online supplement.
              Article 0 comments Cited 912 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Ozge Soyer:
                ORCID: https://orcid.org/0000-0002-7444-251X
                ozgeusoyer@gmail.com
                Journal
                Journal ID (nlm-ta): Pediatr Pulmonol
                Journal ID (iso-abbrev): Pediatr Pulmonol
                Journal ID (doi): 10.1002/(ISSN)1099-0496
                Journal ID (publisher-id): PPUL
                Title: Pediatric Pulmonology
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 8755-6863
                ISSN (Electronic): 1099-0496
                Publication date (Electronic): 14 May 2022
                Publication date (Print): July 2022
                Publication date PMC-release: 14 May 2022
                Volume: 57
                Issue: 7 ( doiID: 10.1002/ppul.v57.7 )
                Pages: 1668-1676
                Affiliations
                [ 1 ] Department of Pediatric Allergy Hacettepe University School of Medicine Ankara Turkey
                [ 2 ] Department of Pediatrics Hacettepe University School of Medicine Ankara Turkey
                [ 3 ] Department of Radiology Hacettepe University School of Medicine Ankara Turkey
                [ 4 ] Department of Pediatric Infectious Disease Hacettepe University School of Medicine Ankara Turkey
                Author notes
                [*] [* ] Correspondence 

                Ozge Soyer, MD, Department of Pediatric Allergy, Hacettepe University School of Medicine, 06100 Ankara, Turkey.

                Email: ozgeusoyer@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-2329-7543
                https://orcid.org/0000-0002-7444-251X
                Article
                Publisher ID: PPUL25949
                DOI: 10.1002/ppul.25949
                PMC ID: 9347415
                PubMed ID: 35502514
                SO-VID: cd75a6cf-9170-4b16-a3e9-66423a976176
                Copyright © © 2022 Wiley Periodicals LLC.
                License:

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                Date revision received : 18 April 2022
                Date received : 02 November 2021
                Date accepted : 23 April 2022
                Page count
                Figures: 2, Tables: 4, Pages: 9, Words: 5384
                Categories
                Subject: Original Article: Asthma
                Subject: Original Articles
                Subject: Asthma
                Custom metadata
                source-schema-version-number 2.0
                cover-date July 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.7 mode:remove_FC converted:03.08.2022

                ScienceOpen disciplines: Pediatrics
                Keywords: asthma,childhood,covid‐19,obesity,small airway dysfunction
                Data availability:
                ScienceOpen disciplines: Pediatrics
                Keywords: asthma, childhood, covid‐19, obesity, small airway dysfunction

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