Several years after being diagnosed with status asthmaticus, overweight and obese children with asthma are at risk of continuing obesity. Because obesity is a potential asthma trigger, interventions are needed to reduce this population’s risk of persistent obesity, according to research results recently published in The Clinical Respiratory Journal.

Researchers conducted a long-term, retrospective, observational cohort study using the TriNetX global federated research network, which includes electronic health record data for pediatric patients 2 to 18 years of age with status asthmaticus. The investigators sought to evaluate persistence of a body mass index (BMI) percentile of ≥85th in children at 5 years after their initial reported diagnosis of status asthmaticus.

The study population (n=129) was divided into 2 groups according to their initial BMI percentile: an underweight/healthy weight group (<85th percentile; n=76) and an overweight/obese group (≥85th percentile; n=53). The average age in the overweight/obese arm was 7.0±3.1 years of age, compared with 5.3±2.7 years of age in the underweight/ healthy arm (P =.002). Sex, race, ethnicity, and the presence of comorbidities were similar in the 2 groups.

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At 5 years after an initial reported diagnosis of status asthmaticus, 39.5% (30 of 76) of those in the underweight/healthy group and 83.0% (44 of 53) of those in the overweight/obese group were reported to have a BMI ≥85th percentile. Further, 60.5% (46 of 76) of those in the underweight/healthy arm and 17.0% (9 of 53) of those in the overweight/obese arm were reported to have a BMI <85th percentile.

Those children who were initially overweight/obese with status asthmaticus had a significantly increased likelihood of continuing to be overweight/obese 5 years following diagnosis compared with children who were underweight/healthy weight at baseline (odds ratio [OR], 7.50; 95% CI, 3.20-17.60; P <.001).

Further analysis showed that sex was associated with obesity 5 years after the initial diagnosis of status asthmaticus, with boys having have a lower association with overweight/obesity in 5 years compared with girls. After controlling for baseline obesity, age, race, and ethnicity, sex was significantly associated with obesity 5 years after the first reported status asthmaticus diagnosis (OR, 0.43; 95% CI, 0.19 to 0.99; P =.04).

Findings from this study reinforce the view that when an obese child presents with status asthmaticus, a detailed assessment of physical activity, nutrition, and asthma control needs to be conducted to reduce the risk for persistent obesity and future asthma exacerbations, said researchers. “Developing wellness strategies can improve the quality of asthma care provided to this patient population,” they noted.

Disclosure: None of the study authors have declared affiliations with biotech, pharmaceutical, and/or device companies. 


Krawiec C, Fang X, Zhou S, Williams D, Thomas NJ. Frequency of persistent obesity 5 years after first time diagnosis of status asthmaticus. Clin Respir J. Published online August 28, 2021. doi:10.1111/crj.13444