Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Feb 24, 2025
Date Accepted: Aug 1, 2025
Comparative analysis of outcomes of influenza and COVID-19 admissions among children with asthma: Analysis of US National Readmission Database
ABSTRACT
Background:
Asthma is a common chronic condition in children, and severe complications can occur with infections like COVID-19 and influenza. There is limited research comparing the in-hospital outcomes of asthmatic children with these infections.
Objective:
This study aims to compare the in-hospital outcomes of these infections in asthmatic children from a population-based perspective.
Methods:
This retrospective study used data from the 2020 United States (US) Nationwide Readmissions Database. Children 1-19 years old with asthma admitted for COVID-19 or influenza infections were eligible for inclusion. Outcomes evaluated included in-hospital mortality, major complications, and 90-day readmission rate. Logistic regression was employed to assess the associations between infection type and outcomes.
Results:
A total of 1,472 hospitalized children with asthma were included, and 405 were admitted due to COVID-19 infection and 1,067 for influenza. After adjustment, the multivariate analysis revealed that children admitted for COVID-19 had a significantly higher risk of sepsis/shock (adjusted odds ratio [aOR] = 4.30, 95% confidence interval [CI]: 1.79-10.32), but a lower risk of bacterial/fungal pneumonia (aOR = 0.37, 95% CI: 0.23-0.61) compared to those who admitted for influenza. No significant different in mortality risk was observed. Stratified analyses by age revealed that among children 1-5 years old, the risk of 90-day readmission was significantly higher those with COVID-19 than influenza (aOR = 3.02, 95% CI: 1.09-8.35).
Conclusions:
US children with asthma hospitalized for COVID-19 had higher risks of sepsis/shock compared to those admitted for influenza, while children admitted for influenza had higher risk for bacterial/fungal pneumonia.
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