COVID-19 pandemic has provoked a huge change in daily functioning in millions of people worldwide. The epidemiological measures in prevention of possible infection have increased the possible risks on the mental and physical health.We have conducted a survey in order to investigate the needs and challenges of families with children with chronic respiratory diseases. In this order, we have created a questionnaire with general information about the family, general information about the child with chronic respiratory disease, overall physical and mental health before and during the pandemic, needs and mental health condition of the parents/caregivers.This survey showed that this group of families of children with respiratory disorders have suffered financially in significant way and has changed the way they perform professional and educational patterns due to the pandemic. Most of the children were stable in their physical health, but their mental health has deteriorated. This is probably due to the regular contact with the medical staff, but not with the mental health professionals. This group of children has a significant reduction in their physical activity and increase the hours in front of TV screens. The further effect on the physical and mental health is to be investigated.

BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterised by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.

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The association between asthma and obesity is well known, with several underlying mechanisms. The aim of the study was to evaluate whether metabolic syndrome may be other underlying mechanism related to this association. The study included 112 children (73 boys and 39 girls, mean age 11.1 ± 2.4); out of them 41were overweight, 38 had asthma and a normal body mass index (BMI), and 33 were overweight asthmatics. Serum leptin, adiponectin, glycemia, insulinemia, lipid profile levels (cholesterol and triglycerides) and the homeostasis model assessment (HOMA) index were analyzed as parameters of metabolic syndrome. BMI, waist circumferences (WC), and waist to hips ratio (WHR) were measured as parameters of obesity. Levels of BMI, WC, WHR, HOMA-IR (insulin resistance), and HOMA-AD (adiponectin) were significantly higher in overweight group (p<0.001) and overweight with asthma group compared to asthma (p<0.05). Asthma group had significantly lower level of leptin (p=0.00001) and significantly higher level of glycemia (p=0.0001) compared to overweight group and also compared to overweight with asthma group (p=0.00001 and p=0.001, respectively). A strong positive correlation was observed between leptin, BMI and WC in all three groups as well as between insulinemia and BMI in overweight (r=0.384) and asthma group (r=0.603). A significant strong correlation was also found between HOMA-IR and HOMA-AD with BMI in asthma group for consequently r=620 and r=531.Undoubtedly, there is an association with some parameters of the metabolic syndrome in childhood asthma. However, obesity has been shown to be a major driver of metabolic changes.