Severe asthma features in children: A case-control online survey

Giuliana Ferrante, Stefania La Grutta, Luigia Maria Brunetti, Sabrina Di Pillo, Silvia Montella, Amelia Licari, Marzia Duse, Alfredo Boccaccino, Raffaele Aralla, Nicola Ullmann, Nicola Pietro Consilvio, Laura Tenero, Gian Luigi Marseglia, Maria Elisa Di Cicco, Emanuela Di Palmo, Fabrizio Franceschini, Grazia Fenu, Annarita Cappiello, Mariangela Berardi, Maria Pia NataleLuigi Terraciano, Susanna Esposito, Luigia Brunetti, Luigi Terraciano, Salvatore Cazzato, Maria Francesca Patria, Luciana Indinnimeo, Franca Rusconi, Renato Cutrera, Massimo Pifferi, Giorgio Piacentini, Fabio Cardinale, Enrico Lombardi, Fernando Maria De Benedictis, Eugenio Baraldi, Francesca Santamaria, Luigi Terraciano, Francesca Santamaria

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23 Citazioni (Scopus)

Abstract

Background: Very few studies have explored the distinguishing features of severe asthma in childhood in Europe, and only one study was conducted in Southern Europe. The aim of this study was to provide a detailed characterization of children with severe asthma treated in specialized pediatric asthma centers across Italy. Methods: We conducted a web-based data collection of family, environmental, clinical and laboratory characteristics of 41 patients aged 6-17 years with severe asthma, defined according to the recent guidelines of the European Respiratory Society and the American Thoracic Society, and 78 age-matched peers with non-severe persistent asthma. The patients have been enrolled from 16 hospital-based pediatric pulmonology and allergy centers in Northern, Central, and Southern Italy. Logistic regression analysis assessed the relationship between patients' characteristics and severe asthma or non-severe persistent asthma. Results: Features independently and significantly associated with severe asthma included lifetime sensitization to food allergens [Odds ratio (OR), 4.73; 95 % Confidence Interval (CI), 1.21-18.53; p = 0.03], lifetime hospitalization for asthma (OR, 3.71; 95 % CI, 1.11-12.33; p = 0.03), emergency-department visits for asthma during the past year (OR = 11.98; 95 % CI, 2.70-53.11; p = 0.001), and symptoms triggered by physical activity (OR = 12.78; 95 % CI, 2.66-61.40; p = 0.001). Quality-of-life score was worse in patients with severe asthma than in subjects with non-severe persistent asthma (5.9 versus 6.6, p = 0.005). Self-perception of wellbeing was compromised in more than 40 % of patients in both groups. Children with severe asthma had lower spirometric z scores than non-severe asthmatic peers (all p < 0.001), although 56 % of them had a normal forced expiratory volume in 1 s. No differences were found between the two groups for parental education, home environment, patients' comorbidities, adherence to therapy, exhaled nitric oxide values, and serum eosinophils and IgE . Conclusions: As expected, children with severe asthma had more severe clinical course and worse lung function than peers with non-severe persistent asthma. Unlike previous reports, we found greater sensitization to food allergens and similar environmental and personal characteristics in patients with severe asthma compared to those with non-severe persistent asthma. Psychological aspects are compromised in a large number of cases and deserve further investigation.
Lingua originaleEnglish
Numero di pagine9
RivistaTHE ITALIAN JOURNAL OF PEDIATRICS
Volume42
Stato di pubblicazionePublished - 2016

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

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    Ferrante, G., La Grutta, S., Brunetti, L. M., Di Pillo, S., Montella, S., Licari, A., Duse, M., Boccaccino, A., Aralla, R., Ullmann, N., Consilvio, N. P., Tenero, L., Marseglia, G. L., Di Cicco, M. E., Di Palmo, E., Franceschini, F., Fenu, G., Cappiello, A., Berardi, M., ... Santamaria, F. (2016). Severe asthma features in children: A case-control online survey. THE ITALIAN JOURNAL OF PEDIATRICS, 42.