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Response:
We appreciate this comment; however, we disagree with the authors' statement that there is no evidence that asthma is a risk factor for COVID-19 related morbidity.
The Canadian Pediatric Society statement, which we co-authored, does note no evidence that children are at increased risk of COVID-19 but then states that “a child or youth with asthma infected with COVID-19 could experience…serious morbidity due to combined effects on the respiratory tract.”(1)
There is evidence that adults with asthma are over-represented in adult patients hospitalized with COVID-19, as we assert. These data come from the Centers for Disease Control (CDC) of U.S. report on hospitalizations in March 2020 which notes that amongst adults hospitalized for COVID-19, 27.3% of 18-49yo, 13.2 % of 50-64yo, and 12.9% of those over 65yo had asthma (https://www-cdc-gov.uml.idm.oclc.org/mmwr/volumes/69/wr/mm6915e3.htm). This is much higher than the prevalence of asthma in the general population which is 6.5-8.1% in the United States for these age groups (https://www-cdc-gov.uml.idm.oclc.org/asthma/most_recent_national_asthma_...). As a result, the CDC lists moderate to severe asthma as a risk factor for COVID-19 morbidity and mortality. Our assertion reflects this in the article.
However, we agree with the author that the literature is not consistent internationally and asthma was not over-represented in adults hospitalized in China. As data continue to be collected and analyzed, our knowledge about asthma as a risk factor for COVID-19 related morbidity will evolve.
References
1. Abrams E, T’Jong G, Yang C. Canadian Pediatric Society Practice Point: Paediatric asthma and COVID-19 [Internet]. Available from: https://www.cps.ca/en/documents/position/paediatric-asthma-and-covid-19