Children with asthma not at higher risk of severe COVID, research suggests

A study of nearly 19,000 children who sought care at hospital for COVID-19 during the pandemic shows those with asthma were not at greater risk of serious infection.

young girl holding asthma inhaler
There were no significant differences in markers of disease severity between non-asthma and asthma children in the research. Photo: Getty Images.

In the early coronavirus pandemic, there were contrasting reports on whether asthma was a risk factor for severe COVID-19 infection. While children are considered to be at a lower risk of severe COVID-19 than older age groups, the impact of childhood asthma was also unclear.

Now, research suggests the risk of severe COVID-19 in children with asthma may be no greater than in children without asthma. The study, published recently in The Journal of Asthma and Allergy, found no significant differences in markers of disease severity, such as intensive care unit (ICU) admissions, between non-asthma and asthma children during multiple waves of the pandemic.

“Children with asthma are generally more susceptible to respiratory illnesses like influenza, so it was initially thought they may be vulnerable to severe infection from the COVID virus,” says respiratory epidemiologist and senior author of the study, Dr Nusrat Homaira, from the Discipline of Paediatrics and Child Health, School of Clinical Medicine at UNSW Medicine & Health.

“But our study, based on a substantial sample of children across multiple waves of the pandemic, indicates children with asthma were not at higher risk of severe COVID than children without asthma,” says Dr Mei Chan from the School of Clinical Medicine at UNSW Medicine & Health, who led the analysis.

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For the study, the researchers analysed de-identified data extracted from the medical records of any child aged under 17 years old who sought care at The Sydney Children’s Hospitals Network (SCHN) with a positive PCR test result between January 2020 and May 2022. Of the 18,932 children with confirmed COVID-19 who attended SCHN, 1025 (5.41 per cent) had a prior diagnosis of asthma.

“Asthma is the most common chronic respiratory condition in children in Australia, affecting about one in every 10 school-aged kids,” Dr Homaira says. “So, if COVID was actually a significant trigger for asthma, we would expect to see more asthma presentations in the hospital.”

The researchers then compared the children with previous physician-diagnosed asthma to those without asthma on their risks of developing COVID-19 and disease severity, measured by length of hospital stay, ICU admission, mechanical ventilation uses and mortality. Information on the need for asthma medications, vaccination status and asthma severity were unavailable.