Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden

COVID-19 对儿童哮喘的影响:实践调整和疾病负担

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作者:Nikolaos G Papadopoulos, Adnan Custovic, Antoine Deschildre, Alexander G Mathioudakis, Wanda Phipatanakul, Gary Wong, Paraskevi Xepapadaki, Ioana Agache, Leonard Bacharier, Matteo Bonini, Jose A Castro-Rodriguez, Zhimin Chen, Timothy Craig, Francine M Ducharme, Zeinab Awad El-Sayed, Wojciech Feleszk

Background

It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic.

Conclusions

Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

Methods

An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma.

Objective

To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients.

Results

Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts. Conclusions: Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

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