Pediatric asthma control during the COVID-19 pandemic: a systematic review and meta-analysis

Abstract

Background: During the current ongoing COVID-19 pandemic, studies had reported that patients with asthma would experience increased asthma-associated morbidity because of the respiratory virus SARS-CoV-2 infection, based on experience with other respiratory viral infections. However, some studies suggested that there was no apparent increase in asthma related morbidity in children with asthma, it is even possible that due to reduced exposures due to confinement, such children may have improved outcomes. In order to understand the impact of Covid-19 on asthma control in children, we performed this systematic review and meta-analysis. Methods: We searched PubMed, Embase, and Cochrane Library to find literature from December 2019 to June 2021 related to Covid-19 and children’s asthma control, among which results such as abstracts, comments, letters, reviews and case reports were excluded. The level of asthma control during the COVID-19 pandemic was synthesized and discussed. Results: A total of 20456 subjects were included in 7 studies. Random effect model is used to account for the data. Compared to the same period before the COVID-19 pandemic, asthma exacerbation, asthma admission, emergency room visit reduced a lot. The outcome of use of inhaled corticosteroids and Beta-2 agonists shows no significant difference. Conclusion: Compared to the same period before the COVID-19 pandemic and the measures in response to it, the level of asthma control has been significantly improved. We need to understand the exact factors leading to these improvements and find methods to sustain it.

Allergic diseases and immunodeficiencies in children, lessons learnt from COVID‐19 pandemic by 2022: A statement from the EAACI‐section on pediatrics

“…Although there were detrimental effects on children and young people's physical and mental well-being during the pandemic, some studies reported improvements in seasonal respiratory allergy symptom control, particularly during lockdown measures. 52,53 Nonpharmaceutical interventions, such as handwashing, masks, and social/physical distancing, reduction in the concentrations of traffic-related air pollutants 54,55 and decline in other respiratory infections incidence, may have contributed to reduced impact on allergic disease 56,57 particularly respiratory, [58][59][60][61][62][63] number of exacerbations 59,62,[64][65][66][67][68][69][70][71] and the odds of emergency room visit and/ or hospital admissions. 59,66,[72][73][74][75][76][77][78] Improvements were normally associated with time spent at home, and stronger effects were found in some studies among individuals with severe disease.…”

“…52,53 Nonpharmaceutical interventions, such as handwashing, masks, and social/physical distancing, reduction in the concentrations of traffic-related air pollutants 54,55 and decline in other respiratory infections incidence, may have contributed to reduced impact on allergic disease 56,57 particularly respiratory, [58][59][60][61][62][63] number of exacerbations 59,62,[64][65][66][67][68][69][70][71] and the odds of emergency room visit and/ or hospital admissions. 59,66,[72][73][74][75][76][77][78] Improvements were normally associated with time spent at home, and stronger effects were found in some studies among individuals with severe disease. 52 Despite strong associations of lockdown measures and improvements in allergic children, anxiety levels and perceptions of elevated health risk were increased among carers, 79 regardless of the actual health state of the child.…”

Youth and caregiver asthma functioning and quality of life throughout the COVID-19 pandemic

“…Many have speculated about the potential drivers of observed improvements in youth asthma functioning throughout the course of the pandemic. Hypothesized contributors to improvements include increased adherence to asthma medications, avoidance of the healthcare setting due to fear of contracting COVID-19, improved air quality due to school closures and "work-fromhome" regulations, decreased participation in physical activity outside of the home, decreased exposure to asthma triggers, and decreased potential for viral exposure due to nationwide lockdowns (2,3,7). Additionally, families may have engaged in preventative measures for asthma management following the onset of the pandemic (i.e., refilling prescriptions, coordinating telehealth specialty care appointments) to avoid lapses in care during the healthcare state of emergency.…”