Clinical and Laboratory Characteristics and Comorbidities in Asthma Endotypes in Children.

Objective: To estimate the proportion of eosinophilic and non-eosinophilic (NEA) endotypes in pediatric asthma, and to compare the clinical, and laboratory characterisitics, and different comorbidities between the two endotypes in the children.

Methods: Children aged 5 to 14 years of age with clinical and/or laboratory-confirmed asthma attending the pediatric outpatient department of a tertiary care hospital in Eastern India between October 1, 2023 and March 31, 2024, were included in this cross-sectional study. Complete hemogram, absolute eosinophil count (AEC), IgE, and pulmonary function tests were performed in all patients. Comorbidities associated with asthma were recorded. All patients were managed as per the Global Initiative for Asthma (GINA) guidelines.

Results: Of 150 patients, 133 (88.7%) patients belonged to eosinophilic asthma and 17 (11.3%) belonged to NEA endotypes. A family history of allergy and/or asthma was observed in 83 (55%) participants. Allergic rhinitis (59.3%), exposure to cold (42%), and anxiety (26.7%) were common comorbidities associated with asthma. Prematurity and urticaria were significantly associated with NEA. On regression analysis, the odds of urticaria among the NEA endotype were about 3.7 times higher than the EA endotype, adjusted odds ratio (95% CI) of 4 (1.3, 12.6), P value = 0.02. Other comorbidities, sociodemographic, clinical, and lung function values were similar in both endotypes of asthma.

Conclusion: Eosinophilic asthma is the commonest asthma endotype and allergic rhinitis is the commonest comorbidity observed in children. Comorbidities associated with asthma in children are usually similar in both endotypes except for urticaria which is higher in NEA.