Childhood asthma outcomes during the COVID-19 pandemic : findings from the PeARL multinational cohort
Papadopoulos, Nikolaos G.; Mathioudakis, Alexander G.; Custovic, Adnan; Deschildre, Antoine; Phipatanakul, Wanda; Wong, Gary; Xepapadaki, Paraskevi; Abou-Taam, Rola; Agache, Ioana; Castro-Rodriguez, Jose A.; Chen, Zhimin; Cros, Pierrick; Dubus, Jean-Christophe; El-Sayed, Zeinab Awad; El-Owaidy, Rasha; Feleszko, Wojciech; Fierro, Vincenzo; Fiocchi, Alessandro; Garcia-Marcos, Luis; Goh, Anne; Hossny, Elham M.; Huerta Villalobos, Yunuen R.; Jartti, Tuomas; Le Roux, Pascal; Levina, Julia; Lopez Garcia, Aida Ines; Ramos, Angel Mazon; Morais-Almeida, Mario; Murray, Clare; Nagaraju, Karthik; Nagaraju, Major K.; Navarrete Rodriguez, Elsy Maureen; Namazova-Baranova, Leyla; Nieto Garcia, Antonio; Pozo Beltran, Cesar Fireth; Ratchataswan, Thanaporn; Rivero Yeverino, Daniela; Rodriguez Zagal, Erendira; Schweitzer, Cyril E.; Tulkki, Marleena; Wasilczuk, Katarzyna; Xu, Dan (2021-02-20)
Papadopoulos, N.G., Mathioudakis, A.G., Custovic, A., Deschildre, A., Phipatanakul, W., Wong, G., Xepapadaki, P., Abou-Taam, R., Agache, I., Castro-Rodriguez, J.A., Chen, Z., Cros, P., Dubus, J.-C., El-Sayed, Z.A., El-Owaidy, R., Feleszko, W., Fierro, V., Fiocchi, A., Garcia-Marcos, L., Goh, A., Hossny, E.M., Huerta Villalobos, Y.R., Jartti, T., Le Roux, P., Levina, J., López García, A.I., Ramos, Á.M., Morais-Almeida, M., Murray, C., Nagaraju, K., Nagaraju, M.K., Navarrete Rodriguez, E.M., Namazova-Baranova, L., Nieto Garcia, A., Pozo Beltrán, C.F., Ratchataswan, T., Rivero Yeverino, D., Rodríguez Zagal, E., Schweitzer, C.E., Tulkki, M., Wasilczuk, K., Xu, D. and (2021), Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy, 76: 1765-1775. https://doi.org/10.1111/all.14787
© 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
https://creativecommons.org/licenses/by-nc/4.0/
https://urn.fi/URN:NBN:fi-fe2022033026217
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Abstract
Background: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.
Methods: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control.
Results: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV₁ and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged.
Conclusions: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.
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