Improvement in school‐aged children with asthma during the Covid‐19 pandemic

Abstract

Introduction The coronavirus 2019 disease (Covid‐19) pandemic led to a number of measures being introduced in many countries worldwide. Lockdowns were imposed on individuals aged <18 years, education was delivered online, and mask‐wearing was made compulsory in public places, resulting in an unprecedented period for children. Real‐life data showing how children with asthma are affected by major changes are limited. This study investigated how asthmatic children are affected by pandemic conditions based on real‐life data. Methods Patients with asthma aged 6–18 years followed up from March to May 2019—before the Covid‐19 pandemic—were included in the study. Data from March to May 2020 and 2019 were then compared to reveal the effects of pandemic‐related lifestyle changes on symptoms, frequency of exacerbations, and drug use in asthmatic children. Results Eighty‐six children with asthma aged 6–18 years were included in this study. Time spent inside the home was significantly higher in 2020 than in 2019. Rescue medication requirements and emergency department visits were significantly lower in 2020 compared to 2019 ( p < 0.001). The number of well‐controlled patients with asthma was higher in 2020 than in 2019 ( p < 0.0001). The number of patients using prophylactic drugs within the previous 3 months was lower in 2020 compared to 2019 ( p = 0.007). Conclusion The present study yielded valuable insights, based on real‐life data, into the condition of children over the age of 6 years during the Covid‐19 pandemic. Numbers of asthmatic exacerbations, rescue drug use, and asthma control were positively affected in school‐aged children with asthma during the pandemic.

The impact of COVID‐19 lockdown measures on symptoms control in children with asthma: A systematic review and meta‐analysis of observational cohort studies

“…31 In the case of hospitalizations, the findings were also consistent across all three included studies that examined this endpoint. 31,42,47 More specifically, the study by Sun et al, reported a significant reduction of 76% in the absolute number of hospitalizations for asthma during the lockdown compared to the prelockdown period, while a reduction was also observed in the study by Akelma et al, although the difference in the absolute number of hospitalizations between the two follow-up periods was not statistically significant. Papadopoulos et al reported a prelockdown proportion of patients requiring hospitalization for asthma equal to 13.1%, which fell to 2.0% during the lockdown period, with this reduction being statistically significant.…”

“…In addition, four studies reported changes in the proportion of patients characterized by well-controlled asthma, 39,40,43,47 while five studies reported changes in the proportion of patients characterized by poorly controlled asthma. 42,43,45,47,48 The pooled proportion of patients with wellcontrolled asthma increased during the lockdown period (Supporting Information: Figure 1) and the pooled RR was 1.35 (95% CI: 1.06, 1.71, I 2 : 77.6%) (Figure 3). At the other end, the pooled proportion of patients with poorly controlled asthma decreased during the lockdown period (Supporting Information: Figure 2) and the pooled RR was 0.47 (95% CI: 0.38, 0.57, I 2 : 0.0%) (Figure 4).…”

“…Finally, among the included studies, some additional endpoints were reported, such as asthma symptoms severity, 41,45,48 asthma-related quality of life, 40 unscheduled or acute or general outpatient/clinician visits, 38,40,44 and asthma medication use or treatment adherence. [38][39][40][41][42]44,45,47,48 A quantitative synthesis was not possible for these additional endpoints due to the low number of studies examining each outcome or the different definitions used across the included studies. However, the overall direction of the effects was the same for asthma symptoms and asthma-related quality of life, as an overall improvement in asthma symptoms and asthma severity during lockdown was reported in all studies that addressed these endpoints.…”

“…confidence interval [CI]: 0.75, 3.24, I 2 : 98.4%) (Figure 2). In addition, four studies reported changes in the proportion of patients characterized by well-controlled asthma, 39,40,43,47 while five studies reported changes in the proportion of patients characterized by poorly controlled asthma. 42,43,45,47,48 The pooled proportion of patients with wellcontrolled asthma increased during the lockdown period (Supporting Information: Figure 1) and the pooled RR was 1.35 (95% CI: 1.06, 1.71, I 2 : 77.6%) (Figure 3).…”

Healthcare utilization in Canadian children and young adults with asthma during the COVID-19 pandemic

“…While we also observed a similar spike involving SABA, there are limited literature quantifying asthma rescue medication use early in the COVID-19 pandemic. Instead, most literature on asthma rescue medication like SABA involved longer COVID-19 pandemic periods with little comparisons on usage between the early and later parts of the pandemic [29][30][31]. These authors found an overall decreased use of SABA during COVID-19.…”