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Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort.
Allergy. 2021 06; 76(6):1765-1775.A

Abstract

BACKGROUND

The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes.

METHODS

The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control.

RESULTS

During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged.

CONCLUSION

Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent.

Authors+Show Affiliations

Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK. Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK. North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.Imperial College London, London, UK.INSERM Unit 1019, CNRS UMR 8204, Center for infection and immunity of Lille, Institut Pasteur de Lille, Univ. Lille, Lille cedex, France.Department of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA.Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong.Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece.Pediatric Pulmonology and Allergy DepartmentHôpital Necker-Enfants Malades, Paris, France.Allergy & Clinical Immunology, Transylvania University, Brasov, Romania.Department of Pediatric Pulmonology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.Department of Pediatrics, University Hospital Morvan, Brest, France.Centre de Ressources et de Compétences pour la Mucoviscidose Pneumo-Allergologie, Ventilation, Maladies RespiratoiresRares de l'Enfant CHU Timone-Enfants, Marseille, France.Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.Department of Pediatric Pneumonology and Allergy, The Medical University of Warsaw, Warsaw, Poland.Allergy Department, Bambino Gesù Children's Hospital IRCCS, Roma, Italy.Allergy Department, Bambino Gesù Children's Hospital IRCCS, Roma, Italy.Pediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" Children's University Clinical Hospital, University of Murcia, Murcia, Spain. Institute for Biomedical Research of Murcia, IMIB-Arrixaca; & Network of Asthma and Adverse and Allergic Reactions ARADyAL, Murcia, Spain.Department of Internal Medicine, Rush Medical College, Chicago.Pediatric Allergy and Immunology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.Hospital General Regional 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico, Mexico.Department of Pediatrics and Adolescent Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland.Department of Pediatrics, Groupe Hospitalier Le Havre, Le Havre, France.Pediatric and Child Health Research Institute of the Central Clinical Hospital of the Russian Academy of Sciences, Moskva, Russia.Allergy and Clinical Immunology Service of the University Hospital of Puebla, Puebla, Mexico.Pediatric Pulmonology & Allergy Unit Children's Hospital la Fe, Valencia, Spain.Allergy Center, CUF Descobertas Hospital, Lisbon, Portugal.Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, UK.VN Allergy & Asthma Research Centre, Chennai, India.Department of Allergy & Clinical Immunology, Saveetha Medical College, Chennai, India.Pediatric Allergy and Clinical Immunology Service, Hospital Infantil, til de Mexico Federico Gómez, Mexico City, Mexico.Pediatric and Child Health Research Institute of the Central Clinical Hospital of the Russian Academy of Sciences, Moskva, Russia. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia.Pediatric Pulmonology & Allergy Unit Children's Hospital la Fe, Valencia, Spain.Teaching and Research Department and Paediatric Allergy Department, Hospital with Specialties Juan María de Salvatierra, La Paz, Mexico. Allergy & immunology Department Hospital Infantil de Medico Federico Gomez, Mexico City, Mexico.Department of Allergy and Immunology, Boston Children's Hospital, Boston, MA, USA.Allergy and Clinical Immunology Department, Hospital Universitario de Puebla, Puebla, Mexico.Hospital General Regional 1 "Dr. Carlos Mac Gregor Sánchez Navarro" IMSS, Mexico, Mexico.CHRU de Nancy, Hôpitald'Enfants, Vandoeuvre, France.Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.Department of Pediatric Pneumonology and Allergy, The Medical University of Warsaw, Warsaw, Poland.Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33608919

Citation

Papadopoulos, Nikolaos G., et al. "Childhood Asthma Outcomes During the COVID-19 Pandemic: Findings From the PeARL Multi-national Cohort." Allergy, vol. 76, no. 6, 2021, pp. 1765-1775.
Papadopoulos NG, Mathioudakis AG, Custovic A, et al. Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy. 2021;76(6):1765-1775.
Papadopoulos, N. G., Mathioudakis, A. G., Custovic, A., Deschildre, A., Phipatanakul, W., Wong, G., Xepapadaki, P., Abou-Taam, R., Agache, I., Castro-Rodriguez, J. A., Chen, Z., Cros, P., Dubus, J. C., El-Sayed, Z. A., El-Owaidy, R., Feleszko, W., Fierro, V., Fiocchi, A., Garcia-Marcos, L., ... Xu, D. (2021). Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. Allergy, 76(6), 1765-1775. https://doi.org/10.1111/all.14787
Papadopoulos NG, et al. Childhood Asthma Outcomes During the COVID-19 Pandemic: Findings From the PeARL Multi-national Cohort. Allergy. 2021;76(6):1765-1775. PubMed PMID: 33608919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Childhood asthma outcomes during the COVID-19 pandemic: Findings from the PeARL multi-national cohort. AU - Papadopoulos,Nikolaos G, AU - Mathioudakis,Alexander G, AU - Custovic,Adnan, AU - Deschildre,Antoine, AU - Phipatanakul,Wanda, AU - Wong,Gary, AU - Xepapadaki,Paraskevi, AU - Abou-Taam,Rola, AU - Agache,Ioana, AU - Castro-Rodriguez,Jose A, AU - Chen,Zhimin, AU - Cros,Pierrick, AU - Dubus,Jean-Christophe, AU - El-Sayed,Zeinab Awad, AU - El-Owaidy,Rasha, AU - Feleszko,Wojciech, AU - Fierro,Vincenzo, AU - Fiocchi,Alessandro, AU - Garcia-Marcos,Luis, AU - Goh,Anne, AU - Hossny,Elham M, AU - Huerta Villalobos,Yunuen R, AU - Jartti,Tuomas, AU - Le Roux,Pascal, AU - Levina,Julia, AU - López García,Aida Inés, AU - Ramos,Ángel Mazón, AU - Morais-Almeida,Mário, AU - Murray,Clare, AU - Nagaraju,Karthik, AU - Nagaraju,Major K, AU - Navarrete Rodriguez,Elsy Maureen, AU - Namazova-Baranova,Leyla, AU - Nieto Garcia,Antonio, AU - Pozo Beltrán,Cesar Fireth, AU - Ratchataswan,Thanaporn, AU - Rivero Yeverino,Daniela, AU - Rodríguez Zagal,Eréndira, AU - Schweitzer,Cyril E, AU - Tulkki,Marleena, AU - Wasilczuk,Katarzyna, AU - Xu,Dan, AU - ,, Y1 - 2021/03/24/ PY - 2021/01/24/revised PY - 2020/10/29/received PY - 2021/01/27/accepted PY - 2021/2/21/pubmed PY - 2021/2/21/medline PY - 2021/2/20/entrez KW - COVID-19 KW - childhood asthma KW - coronavirus SP - 1765 EP - 1775 JF - Allergy JO - Allergy VL - 76 IS - 6 N2 - BACKGROUND: The interplay between COVID-19 pandemic and asthma in children is still unclear. We evaluated the impact of COVID-19 pandemic on childhood asthma outcomes. METHODS: The PeARL multinational cohort included 1,054 children with asthma and 505 non-asthmatic children aged between 4 and 18 years from 25 pediatric departments, from 15 countries globally. We compared the frequency of acute respiratory and febrile presentations during the first wave of the COVID-19 pandemic between groups and with data available from the previous year. In children with asthma, we also compared current and historical disease control. RESULTS: During the pandemic, children with asthma experienced fewer upper respiratory tract infections, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison with the preceding year. Sixty-six percent of asthmatic children had improved asthma control while in 33% the improvement exceeded the minimal clinically important difference. Pre-bronchodilatation FEV1 and peak expiratory flow rate were improved during the pandemic. When compared to non-asthmatic controls, children with asthma were not at increased risk of LRTIs, episodes of pyrexia, emergency visits, or hospitalizations during the pandemic. However, an increased risk of URTIs emerged. CONCLUSION: Childhood asthma outcomes, including control, were improved during the first wave of the COVID-19 pandemic, probably because of reduced exposure to asthma triggers and increased treatment adherence. The decreased frequency of acute episodes does not support the notion that childhood asthma may be a risk factor for COVID-19. Furthermore, the potential for improving childhood asthma outcomes through environmental control becomes apparent. SN - 1398-9995 UR - https://www.unboundmedicine.com/medline/citation/33608919/Childhood_asthma_outcomes_during_the_COVID_19_pandemic:_Findings_from_the_PeARL_multi_national_cohort_ L2 - https://doi.org/10.1111/all.14787 DB - PRIME DP - Unbound Medicine ER -