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Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden
Nikolaos G Papadopoulos1, Adnan Custovic2, Antoine Deschildre3
1Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom; Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.
Insights
Children with asthma are not more vulnerable to COVID-19. Pediatric asthma services adapted to the pandemic, with virtual care increasing and disease control improving for many. This suggests better outcomes may be linked to reduced exposures.
Area of Science:
- Pediatric Allergy and Immunology
- Infectious Diseases
- Public Health
Background:
- The impact of coronavirus disease 2019 (COVID-19) on pediatric asthma susceptibility and severity remains unclear.
- Global pediatric asthma services' response to the pandemic requires investigation.
Purpose of the Study:
- To assess the effects of the COVID-19 pandemic on pediatric asthma services.
- To evaluate the pandemic's impact on disease burden in children with asthma.
Main Methods:
- An international online survey distributed to pediatric asthma experts.
- Data collected on service provision, patient disease burden, and COVID-19 clinical course in asthmatic children.
Main Results:
- 91 respondents reported significant disruptions to pediatric asthma services, including reduced appointments and new patient intake.
- Virtual clinics and helplines were widely implemented, leading to a median decrease in consultations.
- Despite service changes, asthma control improved for 20% of patients, with only 10% experiencing negative effects. Reported COVID-19 incidence in children with asthma was not higher than in the general pediatric population.
Conclusions:
- Children with asthma do not face disproportionately higher risks from COVID-19.
- Asthma management outcomes may have improved during the pandemic, potentially due to increased adherence and reduced environmental exposures.
- Pediatric asthma care rapidly adapted, shifting from in-person visits to virtual consultations.
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.
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