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Impact of COVID-19 pandemic on asthma symptoms and management: A prospective analysis of asthmatic children in Ecuador.
World Allergy Organ J. 2021 Jun; 14(6):100551.WA

Abstract

Background

Asthma affects up to 33% of children in Latin American settings. The ongoing COVID-19 pandemic has had a significant impact on access to and use of health services. We aimed to evaluate the impact of the COVID-19 lockdown on asthma exacerbations, medical facility visits, and use of asthma medications in children.

Methods

We used data from a prospective cohort of 213 children aged 5-17 years in 3 Ecuadorian cities and analysed the impact of the COVID-19 lockdown on asthma. Outcomes (asthma exacerbations, emergency room [ER] visits, planned and unplanned outpatient visits, and use of inhaled corticosteroids and Beta-2 agonists) were analysed using repeated Poisson counts (ie, number of events per participant before and during the COVID-19 lockdown).

Results

During compared to before lockdown: a) the number of asthma exacerbations remained constant (IRR, 0.87; 95% CI: 0.72-1.05; p = 0.152); b) outpatient visits (IRR 0.26, 95% CI 0.14-0.47, p < 0.001) declined 74% while ER visits declined 89% (IRR 0.11, 95% CI 0.04-0.32, p < 0.001); and c) there was no change in inhaled corticosteroids use (IRR 1.03, 95% CI 0.90-1.16, P = 0.699) while Beta-2 agonist use increased (IRR 1.32, 95% CI 1.10-1.58, P = 0.003).

Conclusions

In a cohort of Ecuadorian children with asthma, health services attendance decreased dramatically after COVID-19 lockdown, but asthma exacerbations and use of inhaled corticosteroids were unchanged. Future analyses will address the question of the effect of SARS-CoV-2 infection on asthma exacerbations and control in this paediatric population.

Authors+Show Affiliations

Department of Biosciences, Faculty of Chemistry, University of Cuenca, Cuenca, Azuay, Ecuador.Department of Biosciences, Faculty of Chemistry, University of Cuenca, Cuenca, Azuay, Ecuador. Instituto de Ciencias da Saude, Universidade Federal da Bahia, Salvador, Bahía, Brazil.School of Medicine, International University of Ecuador, Quito, Pichincha, Ecuador.Department of Biosciences, Faculty of Chemistry, University of Cuenca, Cuenca, Azuay, Ecuador. School of Medicine, International University of Ecuador, Quito, Pichincha, Ecuador.Faculty of Medicine, University of Azuay, Cuenca, Azuay, Ecuador.Institute of Infection and Immunity, St George's University of London, London, UK.Department of Pediatrics Hospital Vicente Corral Moscoso, Cuenca, Azuay, Ecuador.Universidad San Francisco de Quito School of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hospital General Docente de Calderón, Quito, Pichincha, Ecuador.Hospital Regional Verdi Cevallos, Portoviejo, Manabí, Ecuador.School of Medicine, International University of Ecuador, Quito, Pichincha, Ecuador.Fundação ProAR and Universidade Federal da Bahia, Salvador, Brazil.School of Medicine, International University of Ecuador, Quito, Pichincha, Ecuador.School of Medicine, International University of Ecuador, Quito, Pichincha, Ecuador. Institute of Infection and Immunity, St George's University of London, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34141051

Citation

Ochoa-Avilés, Angélica M., et al. "Impact of COVID-19 Pandemic On Asthma Symptoms and Management: a Prospective Analysis of Asthmatic Children in Ecuador." The World Allergy Organization Journal, vol. 14, no. 6, 2021, p. 100551.
Ochoa-Avilés AM, Ochoa-Avilés C, Morillo-Argudo DA, et al. Impact of COVID-19 pandemic on asthma symptoms and management: A prospective analysis of asthmatic children in Ecuador. World Allergy Organ J. 2021;14(6):100551.
Ochoa-Avilés, A. M., Ochoa-Avilés, C., Morillo-Argudo, D. A., Molina-Cando, M. J., Rodas-Espinoza, C. R., Chis Ster, I., Maestre Calderón, M. P., Maldonado G, A., Arteaga Vaca, K., Rodriguez, A., Cruz, A. A., Romero-Sandoval, N., & Cooper, P. J. (2021). Impact of COVID-19 pandemic on asthma symptoms and management: A prospective analysis of asthmatic children in Ecuador. The World Allergy Organization Journal, 14(6), 100551. https://doi.org/10.1016/j.waojou.2021.100551
Ochoa-Avilés AM, et al. Impact of COVID-19 Pandemic On Asthma Symptoms and Management: a Prospective Analysis of Asthmatic Children in Ecuador. World Allergy Organ J. 2021;14(6):100551. PubMed PMID: 34141051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of COVID-19 pandemic on asthma symptoms and management: A prospective analysis of asthmatic children in Ecuador. AU - Ochoa-Avilés,Angélica M, AU - Ochoa-Avilés,Cristina, AU - Morillo-Argudo,Diana A, AU - Molina-Cando,María José, AU - Rodas-Espinoza,Claudia R, AU - Chis Ster,Irina, AU - Maestre Calderón,Manolo P, AU - Maldonado G,Augusto, AU - Arteaga Vaca,Karen, AU - Rodriguez,Alejandro, AU - Cruz,Alvaro A, AU - Romero-Sandoval,Natalia, AU - Cooper,Philip J, Y1 - 2021/06/05/ PY - 2020/12/30/received PY - 2021/03/23/revised PY - 2021/04/26/accepted PY - 2021/6/18/entrez PY - 2021/6/19/pubmed PY - 2021/6/19/medline KW - Asthma KW - COVID-19 KW - Children KW - Ecuador KW - Lockdown SP - 100551 EP - 100551 JF - The World Allergy Organization journal JO - World Allergy Organ J VL - 14 IS - 6 N2 - Background: Asthma affects up to 33% of children in Latin American settings. The ongoing COVID-19 pandemic has had a significant impact on access to and use of health services. We aimed to evaluate the impact of the COVID-19 lockdown on asthma exacerbations, medical facility visits, and use of asthma medications in children. Methods: We used data from a prospective cohort of 213 children aged 5-17 years in 3 Ecuadorian cities and analysed the impact of the COVID-19 lockdown on asthma. Outcomes (asthma exacerbations, emergency room [ER] visits, planned and unplanned outpatient visits, and use of inhaled corticosteroids and Beta-2 agonists) were analysed using repeated Poisson counts (ie, number of events per participant before and during the COVID-19 lockdown). Results: During compared to before lockdown: a) the number of asthma exacerbations remained constant (IRR, 0.87; 95% CI: 0.72-1.05; p = 0.152); b) outpatient visits (IRR 0.26, 95% CI 0.14-0.47, p < 0.001) declined 74% while ER visits declined 89% (IRR 0.11, 95% CI 0.04-0.32, p < 0.001); and c) there was no change in inhaled corticosteroids use (IRR 1.03, 95% CI 0.90-1.16, P = 0.699) while Beta-2 agonist use increased (IRR 1.32, 95% CI 1.10-1.58, P = 0.003). Conclusions: In a cohort of Ecuadorian children with asthma, health services attendance decreased dramatically after COVID-19 lockdown, but asthma exacerbations and use of inhaled corticosteroids were unchanged. Future analyses will address the question of the effect of SARS-CoV-2 infection on asthma exacerbations and control in this paediatric population. SN - 1939-4551 UR - https://www.unboundmedicine.com/medline/citation/34141051/Impact_of_COVID_19_pandemic_on_asthma_symptoms_and_management:_A_prospective_analysis_of_asthmatic_children_in_Ecuador_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/34141051/ DB - PRIME DP - Unbound Medicine ER -