Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Dec 25, 2023; 12(5): 272-285
Published online Dec 25, 2023. doi: 10.5501/wjv.v12.i5.272
COVID-19 frequency and clinical course in children with asthma
Muhammet Cihat Özata, Ümmügülsüm Dikici, Öner Özdemir
Muhammet Cihat Özata, Medical Faculty, Sakarya University, Adapazarı 54100, Sakarya, Türkiye
Ümmügülsüm Dikici, Öner Özdemir, Department of Pediatric Allergy and Immunology, Sakarya University, Adapazarı 54100, Sakarya, Türkiye
Author contributions: Özata MC, Dikici Ü and Özdemir Ö designed the research; Özata MC and Dikici Ü performed the research; Dikici Ü and Özdemir Ö contributed analytic tools; Özata MC and Özdemir Ö analyzed the data; Özata MC, Dikici Ü and Özdemir Ö wrote the paper.
Institutional review board statement: This study's approval was obtained from the Sakarya University Faculty of Medicine clinical research ethics committee (Decision no: E-71522473-050.01.04-128344-122).
Informed consent statement: All study participants or their legal guardians, provided informed written consent before enrollment.
Conflict-of-interest statement: The authors have no conflict to disclose.
Data sharing statement: The data supporting this study's findings are available on request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Öner Özdemir, MD, Professor, Department of Pediatric Allergy and Immunology, Sakarya University, Adnan Menderes cad, Adapazarı 54100, Sakarya, Türkiye.
Received: July 26, 2023
Peer-review started: July 26, 2023
First decision: September 4, 2023
Revised: September 13, 2023
Accepted: November 30, 2023
Article in press: November 30, 2023
Published online: December 25, 2023

The epidemic of severe acute respiratory syndrome coronavirus 2 infection, known as the coronavirus disease 2019 (COVID-19), has caused a global health concern. Since its emergence, numerous studies have focused on various clinical manifestations and outcomes in different populations. However, studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are controversial.


To fill this research gap by retrospectively evaluating the course, laboratory, and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had COVID-19.


The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing system. The data included retrospective evaluation of pulmonary function test results before and after COVID-19, routine hematological and biochemical parameters, sensitization states (total IgE, specific IgE, and skin prick test results), and radiological (computed tomography) findings. To inquire about the course and symptoms of COVID-19, asthma patients or their parents were then called and evaluated with a questionnaire.


As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5, it was determined that 414 (7.5%) patients had COVID-19. The mean age of 414 patients was 17.18 ± 4.08 (min: 6; max: 28) years. Two hundred and three of our 414 patients are male, and 211 are female. When their vaccination status was questioned, 21.5% were vaccinated. When the symptoms of our 290 patients were questioned, it was stated that 59.0% had fever symptoms. The rate of using regular prophylactic asthma medications was 19%. The rate of using salbutamol in asthma was found to be 22%. The rate of patients using methylprednisolone was 1%. Emergency service admission was 17.2%, and hospitalization was found to be 4.8%. Leukopenia (< 4000) was found in 14.1% of patients, and 8.08% of our patients had neutropenia (< 1500). Lymphopenia (< 1500) was detected in 44.4% of patients, and lymphocytosis (> 4000) was found in 5.05% of patients. In 65% of our patients, the C-reactive protein value was elevated. A high aspartate aminotransferase and alanine aminotransferase value was detected in 3.2% and 5.4% of patients were found, respectively. 31% of patients had an elevated lactate dehydrogenase value. Typical radiological findings for COVID-19 were detected in 3/309 of patients.


According to our study, there is a correlation between the severity of COVID-19 and asthma symptoms and the course of the disease. However, it is worth noting that the retrospective nature of the study and the differences in sample size, age, and demographic characteristics between the two groups do not allow for an optimal comparison. Therefore, further investigation is needed to explore the relationship between COVID-19 and asthma, and it can be suggested that COVID-19 may trigger asthma attacks and asthma may impact the course of COVID-19.

Keywords: COVID-19, SARS-CoV-2, Children, Asthma, Exacerbation, Allergy

Core Tip: In our comprehensive retrospective study, we have made a noteworthy observation indicating a correlation between the severity of coronavirus disease 2019 (COVID-19) and the presence of asthma symptoms, which also appear to influence the course of the disease. These findings offer valuable insights into the potential interaction between COVID-19 and asthma. Given the complexity of this relationship and its possible implications for patient management, further in-depth investigations are warranted to elucidate the precise mechanisms and associations at play, aiming to improve our understanding and management of both conditions.