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Pediatric Asthma Management During the COVID-19 Pandemic: Results of a National Survey
Silvia Sánchez-García1, Javier Ruiz-Hornillos2,3,4, Carmelo Escudero1
1Allergy Department, Hospital Infantil Universitario Niño Jesús and ARADyAL-RETICs Network, Instituto de Salud Carlos III, Madrid, Spain.
Insights
Pediatric asthma management faced challenges during COVID-19, with reduced follow-up and testing. Severe asthma units and technology are vital for future pandemic control in pediatric asthma patients.
Area of Science:
- Pediatric Pulmonology
- Infectious Disease Epidemiology
- Healthcare Management
Background:
- The COVID-19 pandemic raised concerns regarding optimal control of pediatric asthma patients.
- Effective management strategies for chronic respiratory conditions in children during public health crises are essential.
Purpose of the Study:
- To assess pediatric asthma patient follow-up and management during the COVID-19 pandemic.
- To identify factors influencing care, such as geographic location and healthcare setting.
Main Methods:
- A national survey of specialists managing pediatric asthma patients was conducted.
- Data analyzed included follow-up methods, complementary tests, health system type, severe asthma unit availability, and COVID-19 prevalence.
- Statistical analysis employed contingency tables and Pearson's chi-squared test.
Main Results:
- Reduced face-to-face care and testing (especially pulmonary function tests) were observed, particularly in high COVID-19 prevalence areas.
- 42.7% of respondents perceived reduced or non-existent asthma follow-up compared to pre-pandemic periods.
- Specialists in severe asthma units performed more pulmonary function tests.
Conclusions:
- Pediatric asthma control requires attention, especially during global health emergencies.
- Severe asthma units and technological advancements are crucial for maintaining care during pandemics.
Abstract:
During the COVID-19 pandemic specialists were concerned about how to achieve the best control of pediatric asthmatic patients. A national survey was performed. Analysis of the mean of follow-up, complementary tests, health system (public/private/both), availability of severe asthma units, and geographic location (cities with high COVID-19 prevalence vs. other cities with low prevalence). Differences were analyzed using contingency tables and Pearson's chi-squared test. We obtained 95 responses, mostly from cities with a high disease prevalence (39; 52%). Only 29 (38.6%) of respondents provided care in a severe asthma unit. Severe asthmatic children were followed up mainly by telephone (68; 90.7%) and by in-person visits (32; 42.7%). Face-to-face care was less frequent in cities with a high prevalence of COVID-19 when compared with smaller cities (P = 0.044). Some of the surveyed physicians had discontinued patient follow-up as they were caring for patients with COVID-19 (7; 9.3%). Of all specialists surveyed, 45.3% did not evaluate severe asthmatic children with any means of testing. Pulmonary function tests were scarcely implemented. Blood tests were the most common test performed (45.3%). Specialists working in a severe asthma unit carried out more pulmonary function tests (P = 0.019). Peculiarly, moderate persistent asthmatics underwent more spirometries in cities with a high prevalence rate (P = 0.03). Follow-up of asthmatic children during the pandemic was perceived to be reduced or altogether inexistent by 42.7% of respondents when compared with a similar season outside of this emergency situation. Remarkably, the perception that better management of asthma was delivered during the pandemic by those working in cities with a high prevalence of COVID-19 versus other regions. Pediatric asthma control is crucial to decrease the future risk presented by the condition. New technologies and severe asthma units may become key tools in global health emergencies such as the COVID-19 pandemic.
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