Preschool Asthma Children: Navigating COVID-19's Impact on Treatment Adherence

Area of Science:

• Pediatric Pulmonology
• Epidemiology
• Public Health

Background:

• Persistent asthma requires long-term management, particularly in preschool children.
• The COVID-19 pandemic introduced unprecedented challenges to healthcare and daily life.
• Understanding treatment adherence during public health crises is crucial for pediatric asthma care.

Purpose of the Study:

• To investigate long-term asthma treatment adherence in preschool children with persistent asthma.
• To compare adherence rates and influencing factors in the year before and the first year of the COVID-19 pandemic.
• To identify reasons for treatment discontinuation during the pandemic.

Main Methods:

• A cohort of preschool children on daily inhaled corticosteroids (ICSs) for persistent asthma was studied.
• Treatment adherence, causes for discontinuation, and potential influencing factors (respiratory infections, preschool attendance) were assessed via surveys.
• Medical records were used to evaluate asthma exacerbations and control.

Main Results:

• Adherence to daily inhaled corticosteroid treatment decreased by approximately 50% during the first year of the pandemic.
• The primary reason cited for discontinuation was the absence of asthma symptoms (90.6%).
• Factors like respiratory infections, COVID-19 exposure, preschool attendance, and smoking did not significantly influence adherence during the pandemic year, unlike ICS dosage in the pre-pandemic year.

Conclusions:

• Adherence to inhaled corticosteroid therapy in preschool children with persistent asthma was halved during the initial COVID-19 pandemic year.
• Traditional factors influencing treatment adherence were not significant during the pandemic.
• The pandemic's unique circumstances likely altered adherence patterns, necessitating revised management strategies for pediatric asthma.