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Preschool children with asthma during the Covid-19 pandemic: fewer infections, less wheezing
Zülfikar Akelma1,2, Sema Çetin1, Nevzat Başkaya1
1Pediatric Allergy and Immunology Clinic, Dr. Sami Ulus Maternity and Children's Research and Training Hospital, Ankara, Türkiye.
Insights
COVID-19 pandemic lockdowns positively impacted preschool children with asthma. Fewer respiratory infections led to decreased wheezing, fewer emergency visits, and better asthma control.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic prompted unprecedented public health measures, including lockdowns.
- Preschool children with asthma represent a vulnerable population susceptible to respiratory infections and asthma exacerbations.
Purpose of the Study:
- To evaluate the impact of COVID-19 pandemic precautionary measures on preschool children with asthma.
- To assess changes in asthma symptom control and respiratory infection rates during the pandemic lockdown.
Main Methods:
- Retrospective analysis of preschool children (18-60 months) with asthma treated at a single clinic.
- Comparison of data from March-May 2019 (pre-pandemic) and March-May 2020 (during lockdown).
- Evaluation of questionnaires and asthma symptom control tests, including upper and lower respiratory tract infections (URTIs/LRTIs), pediatric emergency department (PED) visits, and hospitalizations.
Main Results:
- A significant decrease in URTIs, LRTIs, and antibiotic use was observed in 2020 compared to 2019 (p<.01).
- Pediatric emergency department visits and hospitalizations were significantly lower in 2020 (p<.05).
- Asthma symptom control improved significantly in 2020, with a higher proportion of children well-controlled (p<.01).
Conclusions:
- Lockdown measures during the COVID-19 pandemic positively influenced preschool children with asthma.
- Reduced respiratory infections correlated with decreased wheezing and improved asthma symptom control.
- The findings suggest that minimizing exposure to respiratory infections benefits asthmatic children.
Introduction:
A few studies have already investigated preschool children with asthma during the pandemic. The purpose of this research was to investigate how preschool children with asthma were affected by the precautionary measures adopted during the pandemic.
Methods:
Preschool children with asthma aged 18-60 months evaluated in our clinic in March-May 2019, before the Covid-19 pandemic, were included in the study. The lockdown continued during March, April, and May 2020. The questionnaires and asthma symptom control tests for preschool children with asthma in 2019 and 2020 were then evaluated.
Results:
Sixty-three preschool children with asthma, 37 boys and 26 girls, aged 18-60 months (median 47) were included in the study. The median number of upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs), and the use of antibiotics were significantly lower in 2020 than 2019 (p<.01). The median numbers of the pediatric emergency department (PED) visits and hospitalizations were also lower in 2020 than in 2019 (p<.05). In 2019, 31 children with asthma were well controlled, 28 were partly controlled, and 4 were uncontrolled, compared to 58 well controlled, four partly controlled, and one uncontrolled in 2020 (p<.01).
Conclusions:
Preschool children with asthma have been positively affected in terms of PED admission, hospitalization, and asthma symptom control in association with the Covid-19 pandemic and the resulting lockdown measures. This study revealed that wheezing decreased significantly in the absence of respiratory infection in preschool children with asthma. Namely, fewer infections meant less wheezing.
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