Correlation between the severity of asthma and computed tomography-based large airway structural changes among children under 3 years of age

ABSTRACT BACKGROUND: The absence of objective and quantitative criteria of pediatric asthma is a persistent barrier in the early diagnosis and assessment of severity. Alterations in major airway structures in individuals with asthma may indicate the severity of the disease. This study was conducted to determine the correlation between the morphologic characteristics of the respiratory tract with the degrees of the severity of asthma among the children under 3 years old. METHODS: A retrospective analysis of low-dose computed tomography (CT) data was performed to determine the potential predictive value of morphologic characteristics of big airways in determining the response to pharmacologic treatment in children with asthma <3 years of age. The analysis was performed using a machine learning approach. RESULTS: Two hundred and forty-four children with asthma were diagnosed with moderate ( n = 164) and severe ( n = 80) asthma by observing the drug treatment responses. When comparing across groups, patients with severe asthma displayed a greater degree of uneven wall thickness and ellipticity in the airways. This finding indicates that there are subtle alterations in the morphologic structure of big airways in children with severe asthma. In addition, the airway morphologic data were utilized to accurately classify moderate and severe cases, achieving an area under the receiver operating characteristic curve of 0.83 and an accuracy of 0.79. CONCLUSION: The morphologic characteristics of the respiratory tract are closely related to the degrees of the severity of asthma among the children under 3 years old.