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Poorly controlled asthma puts children at ‘much higher risk’ of Covid hospitalisation

Children with poorly controlled asthma have an increased risk of hospitalisation from Covid-19 and should be considered for vaccination, according to research from the University of Edinburgh.

The researchers found that children with poorly managed asthma were three to six times more likely to be hospitalised with Covid-19 than those without asthma. 

Offering these children vaccinations would benefit over 109 000 children throughout the UK and reduce the spread of Covid-19 in schools and households. 

The ‘urgent analysis’ was undertaken at the request of the Joint Commission on Vaccination and Immunisation (JCVI) to identify whether children with asthma should be vaccinated. The results are published in The Lancet Respiratory Medicine.

Asthma is one of the most common chronic childhood disorders, affecting around 1.1 million children in the UK. 

The researchers defined poorly controlled asthma as having been hospitalised due to asthma previously or being prescribed at least two courses of oral steroids in the last two years. 

Together with four other Scottish Universities and Public Health Scotland, the research team analysed the health records of over 750 000 children aged five to 17 years old, 63 463 of whom were children diagnosed with asthma. The data was part of the EAVE II project, a patient data set tracking Scotland’s pandemic and vaccine effectiveness.

Between March 2020 and July 2021, there were 4 339 cases of Covid-19 amongst children with asthma, 67 of whom were admitted to hospital. For every 100 000 children, 255 with poorly controlled asthma were hospitalised with Covid-19, compared to 91 per 100 000 in children with well-controlled asthma and 54 per 100 000 in children without asthma. 

Professor Aziz Sheikh, EAVE II study lead from the University of Edinburgh, said: ‘Our national analysis has found that children with poorly controlled asthma are at much higher risk of Covid-19 hospitalisation.  Children with poorly controlled asthma should therefore be considered a priority for Covid-19 vaccination alongside other high-risk children.’

The findings highlight the importance of maintaining good asthma control in children, particularly during the pandemic. 

Professor Chris Robertson from Public Health Scotland and the University of Strathclyde added: ‘Covid-19 can be a severe disease among children, and this study has provided additional insight into which conditions can put some young individuals more at-risk. We hope the findings can assist the JCVI with its efforts to identify those who should be eligible for the vaccine and further extend the offer of protection to those most vulnerable to the virus.’