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Less respiratory viral exposure leads to fewer asthma exacerbations

Published: November 13, 2021

At the beginning of the COVID-19 pandemic, there was grave concern that asthmatics might be at increased risk of severe outcomes. However, in the first few months of the pandemic it became clear there was a decrease in asthma exacerbations in children. What remained unclear was why that may be the case. Leading hypotheses included effects on key asthma flare triggers: reduced sharing of respiratory viruses due to public health measures, reduced pollution secondary to reduced commuting or, less likely, a decrease in outdoor environmental allergens.

Sayed, et al. examined the frequency of asthma exacerbations over the first year of the COVID-19 pandemic and measured three key factors that impact asthma exacerbations. This manuscript in The Journal of Allergy and Clinical Immunology: In Practice evaluated respiratory viral test results in our health network and both locally measured pollen levels and air pollutants.

Respiratory viral testing showed dramatic decreases in respiratory viral infections through the first year of the COVID-19 pandemic. There was no clear difference in air pollutants in this time period compared to prior years nor evidence of unusually low aeroallergen levels, though the latter was more challenging to assess. Thus, the study supports the understanding that viral upper respiratory infections are a major driver of pediatric asthma exacerbations and that reducing spread of those viruses can reduce asthma exacerbation frequency.   

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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