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COVID-19 challenges pediatric asthma services but not children with asthma

Published online: June 16, 2020

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic poses a high overall burden to public health but appears to be more burdensome and deadly to people with pre-existing chronic conditions. It has been suggested that asthma, particularly when uncontrolled, may predispose to severe COVID-19 disease, both in adults and children; however, this has not been proven. In a study recently published in The Journal of Allergy and Clinical Immunology: In Practice, Papadopoulos et al., describe the results of a global survey evaluating the experience of experts in childhood asthma on how COVID-19 epidemic affected children with asthma and the impact the epidemic is having on pediatric asthma clinical services all over the world.

An online survey was set up by the Pediatric Asthma in Real Life (PeARL), a think tank comprised of pediatric asthma experts aiming to improve patient care, in collaboration with the World Allergy Organization (WAO) Pediatric Asthma Committee and was completed by 91 experts from 27 countries on 5 continents, caring for an estimated population of >133,000 children with asthma.

COVID-19 has had a profound impact in childhood asthma services, as 39% stopped all physical appointments, 75% limited patients visits and 47% stopped accepting new patients. As a result, the number of consultations was halved to a median 20 patients per week per service. To address clinical needs, most centers launched virtual clinics and helplines. On the other hand, COVID-19 did not appear to disproportionately affect children with asthma. Overall, experts reported better than expected disease control in 20% of their patients during the epidemic, while control was negatively affected in only 10% of children. These beneficial effects may be the result of improved treatment adherence as well as reduced exposure to triggers, such as common respiratory viruses, due to the lock-down. Interestingly, only 15 confirmed cases of COVID-19 were described among the population, and the estimated incidence did not appear to differ from reports of general pediatric cohorts.

The key message is that children with asthma do not appear to be disproportionately affected by COVID-19, an observation that PeARL is further investigating in a multinational cohort.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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