Evaluation of asthma diagnosed patients applying to the çukurova university faculty of medicine pediatric allergy clinic between january 2022 and january 2023: A retrospective study

Objective: Asthma is a common chronic inflammatory disease characterized by reversible and variable airway inflammation, particularly prevalent in childhood. In recent years, numerous studies have been conducted to assess the prevalence, classification, and etiopathological risk factors contributing asthma. This study aimed to investigate the frequency, classification based on age and severity, etiology, and risk factors in children diagnosed with asthma who applied to Çukurova University Hospital, a tertiary care center in our region, over the course of one year. Materials and Methods: Medical records of patients who presented to the Çukurova University Faculty of Medicine Pediatric Allergy Clinic with a diagnosis of asthma between January 2022 and January 2023 were retrospectively reviewed. A total of 202 patients meeting the study criteria, which included the presence of a specific diagnostic code for asthma during the one-year period, were included in the study. Data on patients' gender, age, age at diagnosis, age at admission, initial presentation season, asthma severity at diagnosis, comorbidities, personal risk factors, family history and pedigree, consanguinity between parents, environmental risk factors, laboratory parameters such as blood eosinophil levels, total IgE levels, skin tests, and pulmonary function tests were recorded using a data collection form. The Children's Respiratory and Asthma Control Test (cACT) scores were documented to assess asthma control during follow-up. The study was approved by the Çukurova University Faculty of Medicine Non-interventional Clinical Research Ethics Committee. Results: In the study group, 122 (60.4%) male and 78 (39.2%) female patients were examined. The mean age of the patients was 10.75 ± 4.32 (0.21-23.6) years. The mean age of diagnosis was 5.36 ± 3.41 (0.24-18.4) years. Asthma severity was categorized into two main groups: the first group consisted of intermittent and mild persistent asthma, and the second group consisted of moderate and severe persistent asthma. Among the patients, 176 (87.1%) were classified in the intermittent and mild persistent group, while 25 (12.4%) were classified in the moderate and severe persistent group. When examining other concomitant allergic diseases, 112 (55.4%) had allergic rhinitis, 30 (14.9%) had atopic dermatitis, 30 (14.9%) had food allergy, 10 (5%) had drug allergy, and 7 (3.5%) had a history of anaphylaxis. Allergic rhinitis was the most common comorbidity, and there was no significant difference between the groups. However, food allergy was significantly higher in the first group (p=0.030). Comorbidies were absent in 6.3% of the patients. While there were 40 (25.2%) cases of parental consanguinity in the intermittent and mild persistent group, there were 4 (17.4%) cases in the moderate and severe persistent group. This difference was not statistically significant (p=0.416). Parental asthma was detected most frequently in the family history, with a rate of 26.8%, and there was no difference between the groups. When examining environmental risk factors, tobacco exposure (48.5%) was found to be the most common risk factor, and there was no difference between the groups. However, when assessing the presence of humidity at home, 29 (16.7%) patients in the intermittent and mild persistent group had humidity at home, while 9 (37.5%) patients in the moderate and severe persistent group had humidity at home. This difference was found to be statistically significant (p=0.025). In relation to this, when looking at the results of skin tests, mold allergen was found to be positive in 24 (14%) patients in the intermittent and mild persistent group, while it was positive in 7 (30.4%) patients in the moderate and severe persistent group. The difference between these groups was not statistically significant; however, a significantly higher prevalence of sensitivity to mold allergens was observed in the moderate and severe persistent groups(p=0.064). When examining the effect of blood IgE levels on asthma severity, the mean IgE level was 340.5 ± 591.2 in the intermittent and mild persistent group, while it was 482.8 ± 465.9 in the moderate and severe persistent group. This difference was found to be statistically significant in favor of the moderate/severe persistent asthma group (p=0.009). Blood eosinophil levels were not statistically significant (p=0.885). The follow-up cACT score, as expected, showed a relatively better and stable course in the intermittent and mild persistent group, while a significant improvement was observed in the cACT scores of the moderate and severe persistent group. Conclusion: As a result of our study, we determined that asthma is more common in males. We also determined that allergic rhinitis is the most frequently associated allergic comorbidity. The study emphasized the importance of monitoring infants and young children with food allergies for the development of asthma. Tobacco exposure was identified as a commonly observed risk factor in asthma patients. The presence of humidity and mold at home were identified as significant risk factors for the development of moderate and severe persistent asthma. Our study obtained findings that are consistent with the literature in terms of demographics and risk factors, emphasizing the role of mold is regional. One limitation of this study is that it was conducted immediately after the Covid-19 pandemic, which may have led to differences in the number and distribution of patients who followed up compared to routine controls.