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The impact of COVID-19 lockdown on children with recurrent wheezing and asthma in Spain
Zarife Daoud Pérez1,2, Marcelo Rázquin Arias3, Alejandro López-Escobar4,5
1Pediatrics Pulmonology Department, HM Hospitals, Madrid, Spain.
Insights
During the COVID-19 lockdown, most children with asthma maintained good control and treatment. However, children testing positive for SARS-CoV-2 showed increased hospital admissions and emergency care visits.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- The COVID-19 pandemic necessitated global lockdowns, impacting public health and healthcare access.
- Understanding the effects of these measures on chronic pediatric conditions like asthma is crucial.
Purpose of the Study:
- To assess the impact of COVID-19 lockdown measures on asthma control and maintenance treatment in children with recurrent wheezing and asthma in Spain.
- To investigate the association between SARS-CoV-2 infection and healthcare utilization in this pediatric population.
Main Methods:
- A questionnaire-based study analyzed 475 children with recurrent wheezing or asthma before and after the lockdown.
- Data collected included respiratory history, treatment steps, asthma control levels, and COVID-19 history (including IgG SARS-CoV-2 testing).
Main Results:
- 81.7% of children maintained their asthma treatment, and 87.7% remained well-controlled during lockdown.
- 34.9% required reliever medication, particularly older children.
- Of 233 children tested for IgG SARS-CoV-2, 17 (7.3%) were positive; 7 required emergency care and 2 were hospitalized.
Conclusions:
- COVID-19 lockdown in Spain did not significantly alter maintenance treatments or asthma control for most children.
- Children with recurrent wheezing and asthma who tested positive for SARS-CoV-2 showed a notable increase in emergency department visits and hospital admissions.
Aim:
The rapid spread of a novel human coronavirus SARS-CoV-2 led to drastic measures world-wide. Most countries were forced to declare a national lockdown. We studied the effect of lockdown measures on the level of asthma control and maintenance treatment in children with recurrent wheezing and asthma during the first wave of COVID-19 in Spain.
Methods:
We analysed children with recurrent wheezing or asthma before and after the implementation of the lockdown, by using a questionnaire aimed to examine pre-existing respiratory disorders, step treatment and level of asthma control before/after lockdown, COVID history and laboratory testing including IgG SARS-CoV-2.
Results:
We enrolled 475 asthmatic and pre-school wheezers (60.6% males), mean age 5.6 years. There were no differences in asthma treatment comparing both periods: 81.7% maintained the same treatment (P = 0.103). According to child asthma-control questionnaire, 87.7% remained well controlled during confinement. Nearly, a third of children (34.9%) needed reliever treatment, mainly in older children. Determination of IgG SARS-CoV-2 was performed in 233 children (49.1%) of whom 17 (7.3%) tested positive. Seven patients positive to IgG SARS-CoV-2 were assisted in the emergency department and two required hospital admission.
Conclusions:
During COVID-19 lockdown in Spain, most children with recurrent wheezing and asthma remained well controlled from their underlying disease and did not modify greatly their maintenance treatments. Unexpectedly, we also observed that those children who tested positive to SARS-CoV-2 IgG showed a significant increase in paediatric hospital admissions and attendances to urgent care settings.
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