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Follow-up of children diagnosed with severe asthma before and during the COVID-19 pandemic
Gabriela Peláez1,2, Claudio Castaños1, Juan M Figueroa2
1Department of Pulmonology, Hospital de Pediatría S.A.M.I.C. Prof. Dr. Juan P. Garrahan, the City of Buenos Aires, Argentina.
Insights
Telemedicine effectively followed up children with severe asthma during the COVID-19 pandemic, significantly reducing exacerbations. This approach proved beneficial for managing pediatric severe asthma care.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Healthcare Management
Background:
- The COVID-19 pandemic necessitated adaptations in healthcare delivery for chronic conditions.
- Children with severe asthma require consistent monitoring and management to prevent exacerbations.
Purpose of the Study:
- To evaluate the effectiveness of telemedicine for managing children with severe asthma.
- To compare asthma control, exacerbations, and hospitalizations between in-person and online follow-up periods.
Main Methods:
- Prospective, observational, comparative study of 74 children in a severe asthma program.
- Assessed asthma control, exacerbations, and hospitalizations during an in-person period (IPP) and an online period (OP).
- Compared outcomes between March 2019-2020 (IPP) and April 2020-2021 (OP).
Main Results:
- A 41% reduction in total exacerbations and a 46% reduction in severe exacerbations were observed during the online period.
- Fewer patients experienced exacerbations during the online period (46% vs. 68%).
- No significant difference in hospitalization rates between the two periods.
Conclusions:
- Telemedicine is an effective strategy for the follow-up of children with severe asthma.
- Online follow-up can lead to a significant decrease in asthma exacerbations.
- Telemedicine ensures continuity of care for pediatric severe asthma patients.
Abstract:
During the COVID-19 pandemic, health care strategies were explored to ensure the follow-up of children with severe asthma. This was a prospective, observational, and comparative study. Patients in the severe asthma program of a tertiary care children's hospital were included (n: 74). The extent of control, exacerbations, and hospitalizations during an in-person period (IPP) (March 2019-2020) and an online period (OP) (April 2020-2021) was assessed. A total of 74 patients were enrolled in the IPP compared to 68 (92%) in the OP. During the IPP, 68% (46) of patients had exacerbations versus 46% (31) during the OP (p = 0.003). During the IPP, 135 total exacerbations were recorded compared to 79 during the OP (p = 0.001); this accounted for a 41% reduction. During the IPP, 47% (32) of patients had severe exacerbations versus 32% (22) during the OP (p = 0.048). A total of 91 severe exacerbations were recorded during the IPP compared to 49 during the OP (p = 0.029); the reduction was 46%. No differences were observed in terms of hospitalization (IPP: 10, OP: 6; p = 0,9). Telemedicine was effective for the follow-up of patients with severe asthma.
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