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December 2021

Children with poorly controlled asthma at higher risk from COVID-19



Children with poorly controlled asthma who get COVID-19 are more likely to need hospitalisation than children with well controlled asthma, or those without asthma.

The findings, published in The Lancet Respiratory Medicine journal, suggest that current UK recommendations to offer COVID-19 vaccination to all 12–17 year olds should now be expanded to include children with poorly controlled asthma aged 5 and older – that’s around 110,000 in the UK.

Although the overall risk of children with asthma becoming seriously ill with COVID-19 is low, it is higher in those whose asthma is poorly controlled – 1 in 380 such children were hospitalised with COVID-19.

Lead author Professor Aziz Sheikh from the University of Edinburgh, Scotland, said: ‘The key takeaway from this study is that keeping children’s asthma under control is critical as this greatly reduces the risk of COVID-19 hospitalisation. Vaccinating those with poorly controlled asthma offers an additional important layer of protection from serious COVID-19 outcomes.’

More than 1 million children in the UK are being treated for asthma, and respiratory viruses are one of the most common asthma triggers that can cause rapid worsening or chronic symptoms, especially in children.

The study was carried out at the request of the Joint Committee on Vaccination and Immunisation (JCVI). In total, 752,867 children aged 5-17 years old were included in the analysis. The study found that 5-17 year olds with poorly controlled asthma (defined as being hospitalised with asthma within the past two years) were more likely to be admitted to hospital with COVID-19 (548 COVID-19 hospitalisations per 100,000 children), compared to children with well-controlled asthma (94 hospitalisations per 100,000 children), or without asthma (55 hospitalisations per 100,000 children).

‘Although COVID-19 tends to affect children less severely than adults, our findings underscore the importance of carefully monitoring these children if they become infected with COVID-19 and ensuring that children take their preventive inhalers regularly, go for asthma reviews, and have an up-to-date asthma treatment action plan,’ says co-author Dr Ting Shi from the University of Edinburgh.


Shi T, et al. Lancet Respir Med 2021 Nov 30. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00491-4/fulltext

Practice Nurse 2021;51(10):8