Abstract:What is already known about this topic? Coronavirus disease 2019 has a mild disease course in children and adolescents. Chronic respiratory conditions, including asthma, have been suggested as risk factors; however, asthma in children is highly variable in both triggers and severity.What does this article add to our knowledge? During the pandemic, pediatric asthma services limited consultations and established virtual clinics. However, respondents perceived their patients' asthma control to be retained or even… Show more
“…We previously noted an overall decrease in ED utilization at CHOP, 32 a pattern consistent with that observed in other regions of the country, which included a shift away from in-person care and toward VTM-based care. 33 Our observed decrease in the overall asthma disease burden is also consistent with national survey data. 33 Figure 5 Effects of public health interventions designed to limit viral transmission on asthma features.…”
Section: Discussionsupporting
confidence: 88%
“… 33 Our observed decrease in the overall asthma disease burden is also consistent with national survey data. 33 Figure 5 Effects of public health interventions designed to limit viral transmission on asthma features. Public health interventions designed to limit viral transmission (masking, social distancing, school closures, etc) were associated with a restructuring of asthma care delivery including a reduction in in-person encounters and an increase in VTM-based care.…”
Background
The coronavirus disease 2019 (COVID-19) pandemic caused dramatic changes in daily routines and health care utilization and delivery patterns in the United States. Understanding the influence of these changes and associated public health interventions on asthma care is important to determine effects on patient outcomes and identify measures that will ensure optimal future health care delivery.
Objective
We sought to identify changes in pediatric asthma-related health care utilization, respiratory viral testing, and air pollution during the COVID-19 pandemic.
Methods
For the time period January 17 to May 17, 2015 to 2020, asthma-related encounters and weekly summaries of respiratory viral testing data were extracted from Children's Hospital of Philadelphia electronic health records, and pollution data for 4 criteria air pollutants were extracted from AirNow. Changes in encounter characteristics, viral testing patterns, and air pollution before and after Mar 17, 2020, the date public health interventions to limit viral transmission were enacted in Philadelphia, were assessed and compared with data from 2015 to 2019 as a historical reference.
Results
After March 17, 2020, in-person asthma encounters decreased by 87% (outpatient) and 84% (emergency + inpatient). Video telemedicine, which was not previously available, became the most highly used asthma encounter modality (61% of all visits), and telephone encounters increased by 19%. Concurrently, asthma-related systemic steroid prescriptions and frequency of rhinovirus test positivity decreased, although air pollution levels did not substantially change, compared with historical trends.
Conclusions
The COVID-19 pandemic in Philadelphia was accompanied by changes in pediatric asthma health care delivery patterns, including reduced admissions and systemic steroid prescriptions. Reduced rhinovirus infections may have contributed to these patterns.
“…We previously noted an overall decrease in ED utilization at CHOP, 32 a pattern consistent with that observed in other regions of the country, which included a shift away from in-person care and toward VTM-based care. 33 Our observed decrease in the overall asthma disease burden is also consistent with national survey data. 33 Figure 5 Effects of public health interventions designed to limit viral transmission on asthma features.…”
Section: Discussionsupporting
confidence: 88%
“… 33 Our observed decrease in the overall asthma disease burden is also consistent with national survey data. 33 Figure 5 Effects of public health interventions designed to limit viral transmission on asthma features. Public health interventions designed to limit viral transmission (masking, social distancing, school closures, etc) were associated with a restructuring of asthma care delivery including a reduction in in-person encounters and an increase in VTM-based care.…”
Background
The coronavirus disease 2019 (COVID-19) pandemic caused dramatic changes in daily routines and health care utilization and delivery patterns in the United States. Understanding the influence of these changes and associated public health interventions on asthma care is important to determine effects on patient outcomes and identify measures that will ensure optimal future health care delivery.
Objective
We sought to identify changes in pediatric asthma-related health care utilization, respiratory viral testing, and air pollution during the COVID-19 pandemic.
Methods
For the time period January 17 to May 17, 2015 to 2020, asthma-related encounters and weekly summaries of respiratory viral testing data were extracted from Children's Hospital of Philadelphia electronic health records, and pollution data for 4 criteria air pollutants were extracted from AirNow. Changes in encounter characteristics, viral testing patterns, and air pollution before and after Mar 17, 2020, the date public health interventions to limit viral transmission were enacted in Philadelphia, were assessed and compared with data from 2015 to 2019 as a historical reference.
Results
After March 17, 2020, in-person asthma encounters decreased by 87% (outpatient) and 84% (emergency + inpatient). Video telemedicine, which was not previously available, became the most highly used asthma encounter modality (61% of all visits), and telephone encounters increased by 19%. Concurrently, asthma-related systemic steroid prescriptions and frequency of rhinovirus test positivity decreased, although air pollution levels did not substantially change, compared with historical trends.
Conclusions
The COVID-19 pandemic in Philadelphia was accompanied by changes in pediatric asthma health care delivery patterns, including reduced admissions and systemic steroid prescriptions. Reduced rhinovirus infections may have contributed to these patterns.
“…Uncontrolled asthma may be included as a risk factor for severe COVID-19. [4] A sufficient control of symptoms in children with asthma is key in the current pandemic.…”
Section: Discussionmentioning
confidence: 99%
“…Only about 1% of the entire COVID-19 population are children, being pediatric asthma patients underrepresented in this population. [4] Symptoms tend to be less severe, varying from asymptomatic, to mild-moderate cases. There is no gender difference, and all ages appear to be susceptible to the disease.…”
Background: The Coronavirus disease 2019 caused by SARS-CoV2 virus has rapidly spread worldwide becoming one of the most important challenges humans are facing nowadays. Risk factors for severe outcomes have been identified, but asthma seems not to be one of them. Objectives: To analyze lifestyle before the pandemic in severe pediatric asthma patients in treatment with a monoclonal antibody, belonging to Castellon's Universitary General Hospital Health's Department, and investigate the prevalence of COVID-19 in these patients in order to see if their lifestyle may have influenced the probability of being infected by COVID-19. Methods: A questionnaire was developed asking about: their lifestyle before the pandemic; suggestive COVID-19 symptoms and exposition to the disease; and patients' behavior, asthma control and treatment during the pandemic. Total SARS-Cov-2 antibody tests were performed to all patients. Results: A total of 15 patients were included. All patients had a high social exposure before the pandemic. 2 patients had direct contact with positive COVID-19 patients. Both experienced mild symptoms that could be attributed to the disease, but neither of them had a positive serological test. Most patients followed asthma treatment correctly before and during the pandemic. 13 patients referred good asthma control. Most patients continued monthly monoclonal antibody administration. Serological tests were negative for all patients. Conclusion: Severe asthma pediatric patients in treatment with MAB, do not have an increased susceptibility for being infected by the virus, but in the case that they contracted the disease, evidence says they would have shown very weak symptoms.
“…The most frequent respiratory symptoms were cough (73%), nasal discharge or blockage (60%), wheeze (40%), and breathlessness (40%). Eleven of these children (73%) had mild disease, and 3 (20%) had moderate disease, and only 1 case (6.7%) was hospitalized due to Covid 19 (21).…”
Coronavirus disease 2019 (Covid 19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV 2) and causes lymphopenia, immunosuppression, inefficient T and B cell immunity, cytokine storm, and destructive tissue inflammation. Since COVID 19 is a multi-system disease predominantly affecting the lungs, there is doubt on whether chronic lung diseases place patients at higher risk and SARS CoV2 leads to asthma exacerbation. None of the studies have reported asthma or recurrent wheezing as a comorbidity or risk factor for Covid 19 in children up to now. Notably, further studies are needed to explore the relationship between Covid 19 and asthma to improve clinical practice and decrease morbidity and mortality.
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