Clinical characteristics and diagnostic workup in severe asthma: data from the database of the Italian Pediatric Respiratory Society

Although rare in children, severe asthma is responsible for a heavy burden on families and society. Being a rare condition, every center follows only a limited number of patients, and there is a solid rationale for setting up networks to collect data. We present a first report on clinical features and diagnostic workup of children and adolescents with severe asthma included in the database of the Italian Pediatric Respiratory Society (Società Italiana per le Malattie Respiratorie Infantili – SIMRI). 24 Italian pediatric pulmonology and allergology centers took part in the study. Data were collected from October 2021 to October 2023 on a web-based platform. 207 subjects (60.4% males), with a median age of 13.9 years (range: 6.2-17.9 years) were recruited; 191 (92.2%) were sensitized to aeroallergens, 25.6% were overweight and 15.4% were obese. 60 patients (29%) showed a FEV1 value below 80% of the predicted. The diagnostic workup included a chest computer tomography (CT) scan in 78 patients (37.7%, range 0-83% in each center) and a bronchoscopy in 45 patients (21.7%, range 0-87%). The most frequent abnormal findings on chest CT were bronchial thickening and air trapping. In conclusion, our study provides an overview of the main clinical characteristics of Italian children and adolescents with severe asthma enrolled in participating centers, and it underlines the variability between centers in the diagnostic work-up of these patients.