Social distancing of families with children who have asthma is the best method for preventing coronavirus diseases 2019 (COVID-19), according to a letter to the editor published in Allergy.
COVID-19 affects all ages, and the US Centers for Disease Control and Prevention initially stated that people with chronic lung disease, including moderate severe asthma, and allergy may be at higher risk of developing a more severe course of COVID-19 than healthy people. Very few reports are available on pediatric patients with COVID-19; therefore, researchers analyzed data on pediatric patients referred for COVID-19 at 2 hub hospitals located in Italy.
A total of 40 pediatric patients with COVID-19 (median age, 5 years) were included, with the most common symptoms being fever (67.5%), cough (55%), nasopharyngeal complaints (27.5%), and gastrointestinal symptoms (17.5%). No child reported dyspnea and 8 (20%) children were asymptomatic. Anosmia/dysgeusia was present in 3 (12.5%) of patients and pneumonia was diagnosed in 4 (10%) of children. A total of 24 (60%) children were hospitalized, but only 1 required oxygen therapy and intensive care unit admission. Researchers found only 2 children with allergies (food allergy and allergic rhinitis) and 1child with asthma, and found low counts of peripheral eosinophils.
Compared with a large group (n=120) of children with allergies, children with COVID-19 had significantly (P <.0001) lower eosinophil counts. In fact, 5 (12.5%) children with COVID-19 had no eosinophils. This supports the theory that allergy may be “protective” and that therapies could also have a “protective” effect for respiratory disorders (eg, corticosteroids), although this requires confirmation.
Study limitations included the probable underestimation of the number of infected people, including those who were asymptomatic. In addition, allergic disease prevalence depends on age and the present data were all from young children. Therefore, some data on allergy may have been missed.
“In conclusion, an efficient social distancing of families with asthmatic children remains the best option to prevent COVID‐19,” the authors stated.
Licari A, Votto M, Brambilla I, et al. Allergy and asthma in children and adolescents during the COVID outbreak: what we know and how we could prevent allergy and asthma flares [published online May 17, 2020]. Letter. Allergy. doi: 10.1111/all.14369