Asthma as a Comorbidity in COVID-19 Pediatric ICU Admissions in a Large Metropolitan Children's Hospital

Document Type

Journal Article

Publication Date



Pediatric pulmonology




RATIONALE: Children contribute to 5% of COVID-19-related hospitalizations in the United States. There is mounting evidence suggesting childhood asthma is a risk factor for severe disease. We hypothesized that asthma is associated with longer length of stay (LOS) and need for respiratory support among children admitted to pediatric intensive care unit (PICU) with COVID-19. METHODS: We reviewed 150 charts of children and young adults with a positive SARS CoV2 PCR test admitted to the PICU at Children's National Hospital, Washington, DC between 2020 and 2021. We recorded demographics, anthropometrics, past medical history, clinical course, laboratory findings, imaging, medication usage, respiratory support, and outcomes. Functional Status Scale (FSS), that measures an ICU patient's physical function, was used to characterize children with multiple co-morbidities; FSS and obesity were included as covariates in multivariate analysis. Statistical analysis was performed using SPSS v25.0. RESULTS: Sixty-Eight patients ages 0-21 years met inclusion criteria. Median age was 14.9 years, 55.9% were female, median BMI percentile was 62, and 42.6% were African American. Compared to those without asthma, patients with asthma averaged longer LOS (20.7 vs. 10.2 days, p=0.02), with longer PICU stay (15.9 vs. 7.6 days, p=0.033) and prolonged maximum respiratory support (8.3 vs. 3.3 days, p=0.016). Adjusted for obesity and poor physical function (FSS>6), asthma remained a significant predictor of hospital LOS, PICU LOS, and days on maximum respiratory support. CONCLUSION: Asthma can cause severe disease with prolonged need for maximum respiratory support among children with COVID-19. This article is protected by copyright. All rights reserved.