Children with asthma have a lower risk of developing Covid-19

The protection of this age group will be associated with better disease control, use of corticosteroids in crisis and low expression of an enzyme responsible for inflammation.

From Fernanda Bassett, Agency Einstein

With the emergence of the first cases of coronavirus (SARS-CoV-2) infection, in early 2020, one of the main concerns of pediatricians was to know how it would treat children with asthma. The concerns were justified: Asthma is the most common chronic lung disease in childhood and children, in general, are greatly affected by the effects of respiratory disease. Since the coronavirus attacks the lungs, the scientific community has decided to investigate whether these children are at higher risk for Kovid-19 infection than those without the disease.

Good news, no. A large study published in the scientific journal Pediatrics reviewed health data from 46,900 children aged 5 to 17 in the United States and found that the proportion of children with asthma was similar to the proportion of children with asthma in Covid-19. Developed COVID-19. Children without asthma. The data indicates the period from March 1, 2020 to September 30, 2021 and refers to the period where the Delta variant was dominant – after this period Ômicron was identified.

According to the researchers, of the total records analyzed, 12,648 children were tested for SARS-CoV-2 at least once and 706 (5.6%) tested positive for the disease, without 350 (2.8%) asthma and 356 (2.8%). Asthma Only one child with asthma needed hospitalization for the treatment.

“The results of this work are very important and very strong. What we have seen during the epidemic is that children affected by Covid-19, although significant, had very few cases compared to adults and adults. There are other studies that show that adult asthma patients had higher complications and higher mortality rates from infection. Since the number of cases among children was low, the researchers took a long time to find a sufficient number to reach this conclusion, “said Celso Terra, a pediatrician who is also an intensive care physician at the Albert Einstein Intensive Care Unit in Israel.

One of the hypotheses suggested by researchers for this “protection” in children with asthma is the use of inhaled corticosteroids – which will reduce the inflammation that causes disease in the lungs and also reduce viral replication. “When they have an acute attack, asthma patients use corticosteroids, a powerful anti-inflammatory drug. In the high incidence of covid cases in Brazil and around the world, one treatment for patients was to use corticosteroids, ”Terra recalls.

The second hypothesis suggested by the researchers is that children with asthma will have low expression of the enzyme ACE-2, which is associated with the onset of inflammatory processes in the body by SARS-CoV-2. “It seems that the expression of this enzyme is less in asthma patients than in non-asthma patients. Theoretically, the virus would be less able to attack this organism, “explained the pediatrician.

For Terra, the results of this study further reinforce the fact that universal preventive measures were fundamental to epidemic control and continue: use of masks, hand hygiene and vaccinations. And proper control of chronic disease is also essential to avoid complications.

“This work has shown us that Covid-19 does not affect children with lung disease in the way we had imagined at the beginning of the epidemic. But it shows that the better cared for and controlled asthma in these children, the more protected they are. And that protection doesn’t just happen through drug use. These include basic hygiene measures – frequent hand washing and wearing a mask – as well as immunizations. [nos Estados Unidos a vacinação pediátrica começou antes que o Brasil]. The prognosis is always good when the treatment is followed and the disease is controlled, ”Terra concludes.

Source: Einstein Agency

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