Original Article
Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden

https://doi.org/10.1016/j.jaip.2020.06.001Get rights and content

Background

It is unclear whether asthma may affect susceptibility or severity of coronavirus disease 2019 (COVID-19) in children and how pediatric asthma services worldwide have responded to the pandemic.

Objective

To describe the impact of the COVID-19 pandemic on pediatric asthma services and on disease burden in their patients.

Methods

An online survey was sent to members of the Pediatric Asthma in Real Life think tank and the World Allergy Organization Pediatric Asthma Committee. It included questions on service provision, disease burden, and the clinical course of confirmed cases of COVID-19 infection among children with asthma.

Results

Ninety-one respondents, caring for an estimated population of more than 133,000 children with asthma, completed the survey. COVID-19 significantly impacted pediatric asthma services: 39% ceased physical appointments, 47% stopped accepting new patients, and 75% limited patients' visits. Consultations were almost halved to a median of 20 (interquartile range, 10-25) patients per week. Virtual clinics and helplines were launched in most centers. Better than expected disease control was reported in 20% (10%-40%) of patients, whereas control was negatively affected in only 10% (7.5%-12.5%). Adherence also appeared to increase. Only 15 confirmed cases of COVID-19 were reported among the population; the estimated incidence is not apparently different from the reports of general pediatric cohorts.

Conclusions

Children with asthma do not appear to be disproportionately affected by COVID-19. Outcomes may even have improved, possibly through increased adherence and/or reduced exposures. Clinical services have rapidly responded to the pandemic by limiting and replacing physical appointments with virtual encounters.

Key words

Asthma
Children
Virus
Adherence
COVID-19
SARS-CoV2
Control

Abbreviations used

COVID-19
coronavirus disease 2019
IQR
interquartile range
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2

Cited by (0)

This study was supported by the Respiratory Effectiveness Group (REG). REG has received support from AstraZeneca, Novartis, and Sanofi for continued work on Pediatric Asthma in Real Life. A.G.M. was supported by the National Institute of Health Research Manchester Biomedical Research Centre (NIHR Manchester BRC).

Conflicts of interests: J. Konradsen reports grants from Region Stockholm, during the conduct of the study. N. G. Papadopoulos reports personal fees from ALK, Novartis, Nutricia, HAL, Menarini/FAES Farma, Sanofi, Mylan/MEDA, Biomay, AstraZeneca, GlaxoSmithKline (GSK), MSD, ASIT BIOTECH, and Boehringer Ingelheim and grants from Gerolymatos International SA and Capricare, outside the submitted work. A. Custovic reports personal fees from Novartis, Regeneron/Sanofi, Thermo Fisher Scientific, Boehringer Ingelheim, and Philips, outside the submitted work. A. Deschildre reports grants and personal fees from Stallergenes Greer and personal fees from Novartis, ALK, Teva, GSK, MEDA-MYLAN, CHIESI, AImmune, DBV Technologies, and Astra Zeneca, outside the submitted work. A. G. Mathioudakis reports grants from Boehringer Ingelheim, outside the submitted work. W. Phipatanakul reports grants from the National Institutes of Health (NIH); grants and personal fees from Genentech/Novartis and Sanofi/Rgeneron; personal fees from GSK; and nonfinancial support from Thermo Fisher, Lincoln Diagnostics, Alk Abello, and Monaghen, outside the submitted work. P. Xepapadaki reports personal fees from Nutricia, Nestle, Friesland, Uriach, Novartis Pharma AG, and GSK, outside the submitted work. L. Bacharier reports personal fees from Aerocrine, GSK, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, WebMD/Medscape, Sanofi/Regeneron, Vectura, and Circassia, outside the submitted work. T. Craig reports grants and personal fees from CSL Behring, Dyax, Takeda, BioCryst, and Pharming; personal fees from Grifols; and grants and nonfinancial support from GSK, Regeneron, and Novartis/Genetech, outside the submitted work. F. M. Ducharme reports grants from Thorasys Inc; personal fees from Jean-Coutu Pharmaceuticals; and nonfinancial support from Novartis Canada, and Trudell Medical, outside the submitted work. J. E. Gern reports grants from NIH/National Institute of Allergy and Infectious Diseases; personal fees from Regeneron, Ena Theraputics, and MedImmune, outside the submitted work; and personal fees and stock options from Meissa Vaccines Inc, outside the submitted work. A. Kaplan reports personal fees from Astra Zeneca, Behring, Boehringer Ingelheim, Covis, GSK, NovoNordisk, Novartis, Griffols, Pfizer, Sanofi, Teva, and Trudel, outside the submitted work. P. Kuna reports personal fees from Adamed, Boehringer Ingelheim, AstraZeneca, Berlin Chemie Menarini, Hal, Lekam, Mylan, Novartis, Polpharma, and Teva, outside the submitted work. R. F. Lemanske reports grants from the NIH, Clinical and Translational Science Award (NIH), Childhood Origins of ASThma, and AsthmaNet; nonfinancial support from GSK, Boehringer Ingelheim, Merck, Teva, and the American Academy of Allergy, Asthma & Immunology; and personal fees from LSU, Elsevier, UpToDate, the University of Kentucky, ThermoFischer, and Food Allergy Research and Education Network, outside the submitted work. C. Murray reports personal fees from Novartis, GSK, Astra Zeneca, Thermo Fisher, and Boehringer Ingelheim, outside the submitted work. P. M. C. Pitrez reports grants from AstraZeneca, Chiesi, and Teva and personal fees from Astra Zeneca, Teva, Novartis, Mundipharma, S&D Pharma, and GSK, outside the submitted work. G. C. Roberts reports personal fees from ALK, Allergen Therapeutics, Meda Plus, and Merck; and a patent for the use of sublingual immunotherapy to prevent the development of allergy in at-risk infants, outside the submitted work. The rest of the authors declare that they have no relevant conflicts of interest.

Pediatric Asthma in Real Life Collaborators: Rola Abou Taam, Hugo Azuara, Jacques Brouard, Pierrick Cros, Cindy De Lira, Jean-Christophe Dubus, Teija Dunder, Kamilla Efendieva, Carole Egron, Andrzej Emeryk, Yunuen R. Huerta Villalobos, Nidia Karen, Pascal Le Roux, Julia Levina, Monica Medley, Major Nagaraju, Daniela Rivero Yeverino, Marja Ruotsalainen, Stanley Szefler, Cyril Schweitzer, Berenice Velasco Benhumea, Rosalaura Villarreal, Laurence Weiss, and Anna Zawadzka-Krajewska.

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