Impact of COVID-19 pandemic on asthma symptoms and management: A prospective analysis of asthmatic children in Ecuador

Abstract

Background Asthma affects up to 33% of children in Latin American settings. The ongoing COVID-19 pandemic has had a significant impact on access to and use of health services. We aimed to evaluate the impact of the COVID-19 lockdown on asthma exacerbations, medical facility visits, and use of asthma medications in children. Methods We used data from a prospective cohort of 213 children aged 5–17 years in 3 Ecuadorian cities and analysed the impact of the COVID-19 lockdown on asthma. Outcomes (asthma exacerbations, emergency room [ER] visits, planned and unplanned outpatient visits, and use of inhaled corticosteroids and Beta-2 agonists) were analysed using repeated Poisson counts (ie, number of events per participant before and during the COVID-19 lockdown). Results During compared to before lockdown: a) the number of asthma exacerbations remained constant (IRR, 0.87; 95% CI: 0.72–1.05; p = 0.152); b) outpatient visits (IRR 0.26, 95% CI 0.14–0.47, p < 0.001) declined 74% while ER visits declined 89% (IRR 0.11, 95% CI 0.04–0.32, p < 0.001); and c) there was no change in inhaled corticosteroids use (IRR 1.03, 95% CI 0.90–1.16, P = 0.699) while Beta-2 agonist use increased (IRR 1.32, 95% CI 1.10–1.58, P = 0.003). Conclusions In a cohort of Ecuadorian children with asthma, health services attendance decreased dramatically after COVID-19 lockdown, but asthma exacerbations and use of inhaled corticosteroids were unchanged. Future analyses will address the question of the effect of SARS-CoV-2 infection on asthma exacerbations and control in this paediatric population.

Pediatric asthma control during the COVID‐19 pandemic: A systematic review and meta‐analysis

“…Heterogeneity test analysis suggested that there was heterogeneity ( I 2 = 75%, p = 0.007) (Figure 2A). Sensitivity analysis suggested that after removing Ochoa‐Avilés et al's research, 20 the heterogeneity disappeared ( I 2 = 0%, p = 0.75). The random effects model was used.…”

“…Ten studies, [14][15][16][17][18][19][20][21][22][23] with 22,159 subjects were included for the final meta-analysis. The sample size of the studies ranged from 16 to 18,912.…”

“…Four studies 14,15,20,20,23 were included in this outcome, with 835 cases during COVID-19 pandemic, and 945 cases before COVID-19 pandemic. Heterogeneity test analysis suggested that there was heterogeneity (I 2 = 75%, p = 0.007) (Figure 2A).…”

“…Three studies 15,20,22 were included in this outcome. Heterogeneity test analysis suggested that there was no heterogeneity (I 2 = 0%, p = .87).…”

Asma y COVID-19

“…12 La carencia de exacerbaciones graves que hayan requerido asistencia hospitalaria alude que no existe relación con la infección por SARS-CoV-2/COVID-19 en asma. 13 Los síntomas del SARS-CoV-2/COVID-19, incluyen tos, disnea y opresión en el pecho, condiciones difíciles de distinguir en una exacerbación grave del asma, lo que podría dificultar el diagnóstico y un tratamiento oportuno. 14 No obstante, las sibilancias es un síntoma generalmente no asociado al SARS-CoV-2/COVID-19.…”