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. 2022 Jul 3;9(7):1001.
doi: 10.3390/children9071001.

Asthma Comorbidities: Frequency, Risk Factors, and Associated Burden in Children and Adolescents

Salvatore Fasola  1 , Giuliana Ferrante  2 , Giovanna Cilluffo  3 , Velia Malizia  1 , Pietro Alfano  1 , Laura Montalbano  1 , Giuseppina Cuttitta  1 , Stefania La Grutta  1
Affiliations

Asthma Comorbidities: Frequency, Risk Factors, and Associated Burden in Children and Adolescents

Salvatore Fasola et al. Children (Basel). .

Abstract

Identifying asthma comorbidities in children is fundamental for improving disease management. We aimed to investigate the frequency of allergy-related comorbidities in children and adolescents with asthma, and to identify associated risk factors and disease burden. Between September 2015 and December 2018, 508 asthmatic patients (5-17 years) were consecutively enrolled. Parents answered a standardized questionnaire on the history of disease and risk factors. Comorbidities were classified based on the involvement of respiratory and/or extra-respiratory districts: asthma only (A, 13%), asthma with respiratory comorbidities (AR, 37%), asthma with extra-respiratory comorbidities (AER, 10%), and asthma with both respiratory and extra-respiratory comorbidities (ARER, 40%). Multinomial logistic regression showed that membership in the AR group was significantly associated with a maternal history of asthma (OR = 3.08, 95% CI: 1.23-7.72), breastfeeding ≥ three months (OR = 1.92, 1.06-3.46), early mold exposure (OR = 2.39, 1.12-5.11), and current environmental tobacco smoke exposure (OR = 2.06, 1.11-3.83). Membership in the AER group was significantly associated with the female gender (OR = 3.43, 1.54-7.68), breastfeeding ≥ three months (OR = 2.77, 1.23-6.22). ARER was significantly associated with all the aforementioned exposures. Patients with AR reported exacerbations in the last 12 months more frequently (p = 0.009). Several personal and environmental risk factors are associated with comorbidities in asthmatic children and adolescents, possibly worsening the disease burden.

Keywords: adolescents; asthma; children; comorbidities; risk factors.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart describing the recruitment of individuals.
Figure 2
Figure 2
Estimated odds ratios (orange points) and 95% confidence intervals (bars) from the multinomial logistic regression model. A: asthma only. AR: asthma with respiratory comorbidities. AER: asthma with extra-respiratory comorbidities. ARER: asthma with both respiratory and extra-respiratory comorbidities. ETS: Environmental Tobacco Exposure.
Figure 3
Figure 3
Distribution of VAS, CACT/ACT, PAQLQ, and PSQI scores by group in 225 children/adolescents who completed the questionnaires. Boxplots represent the median (central line), 25th–75th percentiles (box), and min-max non-outlier values (whiskers). A: asthma only. AR: asthma with respiratory comorbidities. AER: asthma with extra-respiratory comorbidities. ARER: asthma with both respiratory and extra-respiratory comorbidities.
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